DIABETIC NEPHROPATHY
(Diabetic Kidney Disease)
Komplikasi Diabetes
Microvascular
Retinopathy
Nephropathy
Neuropathy
peripheral & autonomic
Macrovascular
Cerebrovascular
Cardiovascular
Peripheral vascular
2
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Incidence of ESRD
Resulting from Primary
Diseases (1998)
19%
3%
Diabetic
43%
Nephro-
12%
pathy
23% Diabetes
Hypertension
Glomerulonephritis
Cystic Kidney
Other Causes
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Diabetic Nephropathy
FAKTOR RISIKO
PATOGENESIS
Tanda abnormalitas pertama DN adalah
hipertrofi ginjal, dimana terjadi peningkatan
GFR (Glomerular Fitration rate)
Anatomi Ginjal
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ALBUMINURIA
Stage 1:Hyperfiltration
Stage 2:Basement membrane thickening
Stage 3:Microalbuminuria
Stage 4:Persistent proteinuria
Stage 5:End Stage Renal Failure
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NEFROPATI HIPERTENSI
Pendahuluan
Terbagi 2 :
Hipertensi essesial/ primer
Hipertensi sekunder
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Patogenesis
Heart
Left ventricular hypertrophy
Angina or prior MI
Heart failure
Brain
Stroke or transient ischemia attack
Chronic kidney disease
Peripheral Arterial Disease
Retinopathy
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PATOGENESIS
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Nefropati hipertensi
Biopsi nephrosclerosis
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Nefropati hipertensi
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Kegagalan autoregulasi
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Patogenesis nefrosklerosis
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European Society of
Hypertension (ESH) 2007
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TERAPI : kendali hipertensi dan
faktor risiko lain
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Classification and Management
of BP for adults
Initial drug therapy
BP SBP* DBP* Lifestyle
classification mmHg mmHg modification Without compelling With compelling
indication indications
JNC 7 Guidelines
Lifestyle Modifications
Not at Goal
Blood Pressure
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