Predisposing Factors: Age: 40 years old Obesity Family history of DM type 2

PATHOPHYSIOLOGY

Precipitating Factors: Blood sugar level Blood pressure Age: 75 years old + Family history of DM type 2

Impairment of alpha and beta cells in the pancreas

Failure to produce insulin/ Insulin resistance of peripheral tissues

Bood glucose

Cross-linking of proteins

Glomerular pressure

Lerika, insulin, Glypizide, Genovia

Scarring process in the glomeruli

Microangiopathy (small vessel disease) Na diet

Glomerulosclerosis

Protein leak (micro/macroalbumi nuria/proteinuria)

Edema Albumin=3. 20

Damage to most glomeruli

Iberet Reduced renal reserve

Adaptive hyperfiltration: Normal/near normal crea & BUN, asymptomatic

Renal insufficiency Deranged excretory & secretory mechanisms, Phosphorus: 6.70, RBC 3.4, Crea: 9, BUN: 79, uric acid: 9.60, weakness Mild azotemia, F/E imbalance, urination Renal failure

ESRD

Severe azotemia, acidosis, impaired urine dilution

Complications Hemodialysis Death Pathophysiology Manifestation

Treatment