Diabetic Renal-Retinal Syndrome

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Juli 1998



After a decade or longer, approximately one-third of individuals with either type 1 or type 2 diabetes commence a downhill course in which decreasing renal function and failing vision define a Renal-Retinal Syndrome, dominating all aspects of life and presaging early death. Only a generation ago, survival after onset of end-stage renal disease (ESRD) in diabetes was limited because rehabilitation was preempted by blindness, limb amputation, stroke, and heart disease. By 1998, however, team management has improved the outlook, with preserved sight and return to work and home responsibilities, usually for a decade or longer, following kidney transplantation and laser photocoagulation. Recognition of the critical requirement for blood pressure regulation and metabolic control are central themes in management. In this unique book, the accomplishments of ophthalmologists, nephrologists, diabetologists, transplant surgeons, and basic scientists are blended into a strategic approach that may be readily applied by all those caring for diabetic patients. Each of twenty-one presentations suitable for primary care physicians, as well as for subspecialists concerned with macrovascular and microvascular complications of diabetes, is placed in perspective by an introductory editorial analysis. Promising near-term innovative therapies, including insertion of genetically engineered beta cells or polymer-coated islets of Langerhans, interdiction of kinins that promote retinal angiogenesis, and prevention of synthesis of advanced glycosylated endproducts (AGEs), are presented in detail. While comprehensive care of diabetic patients reflects multiple incremental advances that in sum afford major benefit, this text envisions further remarkable changes likely to suppress and possibly entirely prevent the Diabetic Renal-Retinal Syndrome.


1. Diabetes in the United States: Epidemiology, Scope and Impact; M.I. Harris. 2. Stages of Diabetic Nephropathy; C.E. Mogensen. 3. Mesangial Expansion in Diabetic Nephropathy: Functional and Genetic Considerations; M. Maurer, P. Foiretto. 4. Nephropathy in NIDDAM; E. Ritz, D. Fliser. 5. Clinical Imperatives in Diabetic Nephropathy: The Devastating Impact of Comorbidity; E.A. Friedman. 6. Dialysis in Diabetic Patients: Three Decades of Experience, from 1964 to 1997; M.M. Avram. 7. Hemodialysis in Patients with Diabetes Mellitus; A.M. Miles. 8. Continuous Ambulatory Peritoneal Dialysis in 224 Diabetics with End Stage Renal Disease: Evidence of Improved Survival over the Past 10 Years; D.G. Oreopoulos. 9. The Natural History and Classification of Diabetic Retinopathy; F.A. L'Esperance. 10. Long-Term Visual Outcome of Diabetic Patients Treated with Pan-Retinal Photocoagulation; D.H. Berman. 11. A New Hypothesis on Mechanisms of Retinal Vascular Permeability in Diabetes; T.W. Gardner, et al. 12. Angiogenesis in Diabetic Retinopathy. A History of Accomplishment, Discovery and Promise; L.P. Aiello. 13. Surgical Management of Proliferative Diabetic Retinopathy; T.S. Charles. 14. Heart Disease in Patients with the Diabetic Renal-Retinal Syndrome: Clinical Considerations; L.T. Clark. 15. NO and Diabetic Complications; R.F. Furchgott. 16. Age and the Kidney; H. Vlassara. 17. Xenotransplantation of Encapsulated Porcine Islets; A.M. Sun. 18. Generation of Non-Immunogenic Islet Cells Using Genetic Engineering; M. Brownlee. 19. Insulin-Independence for 10 Years in 32 Pancreas Transplant Recipients from a Historical Era; J.S. Narjarian. 20. Giving up: Discontinuation of Dialysis; C.M. Kjellstrand.


`Altogether, the volume presents a clear overview of some aspects of teh last 20 years' improvements within prevention and treatment of diabetic complications in the kidney and in the eye. The chapters dealing with diabetic retinopathy are well written, reflecting the authors' personal iunterests.'
Acta Ophthalmologica Scandinavica (1999)

EAN: 9780792350491
ISBN: 0792350499
Untertitel: 21st Century Management Now. 1998. Auflage. Book. Sprache: Englisch.
Verlag: Springer
Erscheinungsdatum: Juli 1998
Seitenanzahl: 304 Seiten
Format: gebunden
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