Diabetes remains an important health issue as more patients with chronic and uncontrolled diabetes develop diabetic nephropathy(DN), which classically presents with proteinuria followed by a progressive decrease in re...Diabetes remains an important health issue as more patients with chronic and uncontrolled diabetes develop diabetic nephropathy(DN), which classically presents with proteinuria followed by a progressive decrease in renal function.However, an increasing proportion of DN patients have a decline in kidney function and vascular complications without proteinuria, known as nonproteinuric DN(NP-DN). Despite the increased incidence of NP-DN, few clinical or experimental studies have thoroughly investigated the pathophysiological mechanisms and targeted treatment for this form of DN. In this review, we will examine the differences between conventional DN and NP-DN and consider potential pathophysiological mechanisms, diagnostic markers, and treatment for both DN and NP-DN. The investigation of the pathophysiology of NP-DN should provide additional insight into the cardiovascular factors influencing renal function and disease and provide novel treatments for the vascular complications seen in diabetic patients.展开更多
Background: Maternal and perinatal mortality and morbidity are mainly affected by hypertension during pregnancy (pre-eclampsia). Haemorrhage and cerebral bleeding are the primary and significant complications of pre-e...Background: Maternal and perinatal mortality and morbidity are mainly affected by hypertension during pregnancy (pre-eclampsia). Haemorrhage and cerebral bleeding are the primary and significant complications of pre-eclampsia. Abruption of the placenta and renal failure are among the major complications caused by this disease. The perinatal complications include Intrauterine Growth Restriction (IUGR), Intrauterine Foetal Death (IUFD), neonatal death, and prematurity. Objective: The purpose of the present study was to examine the incidence of Pregnancy-Induced Hypertension (PIH), pre-eclampsia, the management of PIH, including the early diagnosis, the pharmacological drug management used, and the prevalence of maternal and perinatal complications. Methods and Patients: This cross-sectional study took place in Aljalaa maternity hospital, which represented the west of the state of Libya in the period from 1st January 2012 to 31st December 2012, with patients who were diagnosed, managed, and terminated according to protocol management of the hospital. Results: In the present study, from the total deliveries in Aljalaa Maternity hospital, the incidence of PIH is 8.4% and pre-eclampsia is 5.1%. No maternal mortality, CNS haemorrhaged, hepatic failure, or renal failure. The reported maternal complications included: Eclampsia, HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low platelets), abruption placenta, and pulmonary oedema see in eighteen percent, six percent, nine percent, four percent and less than one percent, respectively. The foetal complications were preterm babies and Intrauterine Growth Restriction (IUGR) in nineteen percent, Low Birth Weight (LBW) in twenty-five percent, Intrauterine Foetal Death (IUFD) in five percent, neonatal death in two percent and, perinatal death in six percent. In the PIH patients, the presence of associated symptoms such as headache, blurred vision, irritability, and the presence of signs such as severe hypertension, generalized oedema, exaggerated reflexes, and abnormal investigations (protein urea, high uric acid, abnormal LFT, haemoconcentration, and low pits) increased the risk of maternal and foetal complications. Conclusion: To decrease mother and newborn mortality and morbidity in PIH patients, a rigorous management protocol is required to implement evidence-based guidelines.展开更多
文摘Diabetes remains an important health issue as more patients with chronic and uncontrolled diabetes develop diabetic nephropathy(DN), which classically presents with proteinuria followed by a progressive decrease in renal function.However, an increasing proportion of DN patients have a decline in kidney function and vascular complications without proteinuria, known as nonproteinuric DN(NP-DN). Despite the increased incidence of NP-DN, few clinical or experimental studies have thoroughly investigated the pathophysiological mechanisms and targeted treatment for this form of DN. In this review, we will examine the differences between conventional DN and NP-DN and consider potential pathophysiological mechanisms, diagnostic markers, and treatment for both DN and NP-DN. The investigation of the pathophysiology of NP-DN should provide additional insight into the cardiovascular factors influencing renal function and disease and provide novel treatments for the vascular complications seen in diabetic patients.
文摘Background: Maternal and perinatal mortality and morbidity are mainly affected by hypertension during pregnancy (pre-eclampsia). Haemorrhage and cerebral bleeding are the primary and significant complications of pre-eclampsia. Abruption of the placenta and renal failure are among the major complications caused by this disease. The perinatal complications include Intrauterine Growth Restriction (IUGR), Intrauterine Foetal Death (IUFD), neonatal death, and prematurity. Objective: The purpose of the present study was to examine the incidence of Pregnancy-Induced Hypertension (PIH), pre-eclampsia, the management of PIH, including the early diagnosis, the pharmacological drug management used, and the prevalence of maternal and perinatal complications. Methods and Patients: This cross-sectional study took place in Aljalaa maternity hospital, which represented the west of the state of Libya in the period from 1st January 2012 to 31st December 2012, with patients who were diagnosed, managed, and terminated according to protocol management of the hospital. Results: In the present study, from the total deliveries in Aljalaa Maternity hospital, the incidence of PIH is 8.4% and pre-eclampsia is 5.1%. No maternal mortality, CNS haemorrhaged, hepatic failure, or renal failure. The reported maternal complications included: Eclampsia, HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low platelets), abruption placenta, and pulmonary oedema see in eighteen percent, six percent, nine percent, four percent and less than one percent, respectively. The foetal complications were preterm babies and Intrauterine Growth Restriction (IUGR) in nineteen percent, Low Birth Weight (LBW) in twenty-five percent, Intrauterine Foetal Death (IUFD) in five percent, neonatal death in two percent and, perinatal death in six percent. In the PIH patients, the presence of associated symptoms such as headache, blurred vision, irritability, and the presence of signs such as severe hypertension, generalized oedema, exaggerated reflexes, and abnormal investigations (protein urea, high uric acid, abnormal LFT, haemoconcentration, and low pits) increased the risk of maternal and foetal complications. Conclusion: To decrease mother and newborn mortality and morbidity in PIH patients, a rigorous management protocol is required to implement evidence-based guidelines.
