Case history
Case history #1
A 25-year-old woman with a 12-year history of poorly controlled type 1 diabetes presents with anasarca (severe generalized edema) and impaired vision. She is found to have nephrotic syndrome and proliferative diabetic retinopathy.
Case history #2
A 50-year-old man with a 15-year history of type 2 diabetes presents with edema, fatigue, and impaired sensation in the lower extremities. He is found to have proteinuria, reduced estimated glomerular filtration rate (eGFR), anemia, background diabetic retinopathy, and peripheral neuropathy.
Other presentations
DKD can present with severely increased albuminuria (defined as >300 mg/g albuminuria, previously termed macroalbuminuria) or nephrotic syndrome (characterized by massive proteinuria [>3.0 to 3.5 g albuminuria/day], hyperlipidemia, edema, and hypoalbuminemia), in patients with type 2 diabetes without other microvascular complications (e.g., retinopathy). A temporal change to the clinical manifestations of DKD has been observed, with reduced eGFR without albuminuria becoming more prevalent.[2][3]
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