@article{oai:niigata-u.repo.nii.ac.jp:00018852,
 author = {鈴木, 芳樹},
 issue = {12},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Dec},
 note = {The number of patients with diabetic nephropathy (DMN) and chronic renal failure due to DMN was increasing year by year in Japan. Clinical features of them were very various, many factors might contribute to the cause and development of DMN. Although many investigations of treatment for DMN were reported, a few were established to prevent its progression. Microalbuminuria was recognized to be useful to detect an early phase of DMN, however, our results revealed that mesangial expansion which was the most characteristic histological finding in DMN was already found in patients with microalbuminuria by renal biopsy specimens. From this point, more early and specific markers should be found in patients without renal histological changes. Renal hemodynamics in patients with DMN was different from that in those with chronic glomerulonephritis in some points. More exact and convenient measurements should be needed. And the frequency of hyperfiltration and its participation in the progression of DMN were unclear in patients with NIDDM as well as IDDM. Three major histological parameters, the degree of mesangial expansion, arterio-arteriolo sclerosis and tubulo-interstitial changes, related with GFR and urine protein and determined the prognosis of renal function. Especially, increase in mesangial matrix was resulted from that in some extracellular matrices. At present, many investigators considered that it was caused by increased synthesis and decreased degradation of them, regulating by some cytokines such as TGF-β or PDGF et al. In many trials for treatment of DMN, restricted protein intake and use of angiotensin converting enzyme inhibitor were reported to have beneficial effects on urine protein and renal function. However, the effects of other treatments were controversial, since there were few prospective, placebo-controlled, multicenter-trial for them.},
 pages = {891--897},
 title = {5)糖尿病性腎症(シンポジウム 糖尿病研究の進歩と治療, 第498回新潟医学会)},
 volume = {108},
 year = {1994}
}