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0:00
Hello, I'm Professor
Merlin Thomas from
the Department of Diabetes here
at Melbourne's
Monash University,
and it's my pleasure to be
talking to you today about
chronic kidney disease
in type 2 diabetes.
As you well know,
chronic kidney disease
is a very common occurrence
across the globe.
Most of those cases of
chronic kidney disease
are due to diabetes.
Diabetes is on the rise and
so is chronic kidney disease.
Understanding why
diabetes causes
the damage that it does
and how it progresses to
result in impaired
kidney function and
other comorbidities
associated with
renal disease will be
covered in this talk.
0:44
Just an overview of this talk
to begin with. This talk is
going to cover, first of all,
what is diabetic kidney
disease. Then, second,
how common it is to have
kidney disease in
people with diabetes.
We're then going to look at
how diabetes actually causes
kidney disease and
the underlying
pathophysiological mechanisms.
Fourthly, we're going
to actually look at
the pathological damage that
diabetes does to the kidney.
Finally, we're going
to explore why
that damage is so important for
the lives and the outcomes of
patients with type 2
diabetes in particular.
1:24
Chronic kidney disease
is not something that
you can easily pick up in
patients with diabetes.
In other words, it's not
a clinical diagnosis.
Not like heart failure
or cough or pneumonia.
Most people with
chronic kidney disease
don't know that they have it.
They have few signs or
no symptoms at all.
In fact, many of them completely
ignore their kidneys or
think their kidneys
are working just
fine because they
continue to make urine,
but, in fact, you need to be
able to understand
that patients with
chronic kidney
disease need to be
identified by measurements
of their kidney function.
Most easily done by estimating
their glomerular
filtration rate.
When their glomerular filtration
rate is below a level of
60 ml/min/1.73 m^2
or, if you like, two
standard deviations
below the mean of what
a normal GFR should be.
Then, their GFR is
abnormally low.
Equally in individuals with
an elevated urinary albumin
that implies that the kidney
function is abnormal.
Generally, we don't use the
term diabetic kidney disease
outside of when we talk about
pathology because in
the clinical setting,
It is almost impossible to
determine whether
someone has got
damage due to diabetes or
the comorbidity associated
with their diabetes,
like hypertension, obesity,
and atherosclerotic disease.
