The first factor is the abnormal renal haemodynamics. Renal haemodynamics plays a critical role in the coming into being of Diabetic Nephropathy. When the blood sugar is high, the pressure in capillary wall will increase, which leads to the extension of mesangial area, the fusion of foot process of epithelial cells. The epithelial cells drop from renal basilar membrane, which leads to the ultrafiltration and ultraperfusion. Basilar IV collagen messenger increase, which leads to the increased thickness of basilar membrane. At last, diffusibility and nodositas will come into being, leading to sclerosis. With the increasing of dynamic pressure of renal blood flow, the filtration of protein increases, which leads to the increase of matrix. Nodositas renal glomerular sclerosis comes into being.
The second factor is high blood sugar. In most cases, the occurrence of Diabetic Nephropathy is related to high blood sugar. When the sugar in the blood is not controlled well, high blood sugar and increased adanced glycation end products can lead to the proliferation of mesangial cells and increased matrix. The mesangial area will extend, which can lead to the occurrence of Diabetic Nephropathy.
The third factor is high blood pressure. High blood pressure has no direct connection with Diabetic Nephropathy. But in the high blood pressure(High Blood Pressure and Kidney Disease) stage when there is microalbunminuria, the high blood pressure can lead to the deterioration of renal function, which causes Diabetic Nephropathy.
The fourth factor is genetic factors. People whose parents have had Diabetic Nephropathy are more likely to have Diabetic Nephropathy compared with those whose parents do not have Diabetic Nephropathy.
The fifth factor is the increased blood viscosity and the block of micro-circulation. Blood viscosity and the block of micro-circulation can lead to thrombus easily. Once thrombus comes into being, renal unites will be in the insufficiency of blood and oxygen. Protein in urine will increase and renal function will decline.
The sixth factor is high protein diet. It is also a factor which can bring more burden to the kidney, and cause vicious circle. So for patients with Diabetic Nephropathy, the intake of protein should not be more than 40g.
The last factor is hyperlipidemia, which is common among those with Diabetic Nephropathy. Hyperlipidemia can promote the renal glomerular sclerosis and accelerate the development of Diabetic Nephropathy.
