Overview

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 pre-empted 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 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 21 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 which afford major benefit, this text envisions further remarkable changes likely to suppress and possibly entirely prevent the diabetic renal-retinal syndrome.

Full Product Details

Author:   E.A. Friedman ,  Francis A. L'Esperance Jr.
Publisher:   Springer
Imprint:   Springer
Edition:   1998 ed.
Dimensions:   Width: 17.00cm , Height: 1.70cm , Length: 24.40cm
Weight:   1.330kg
ISBN:  

9780792350491

ISBN 10:   0792350499
Pages:   284
Publication Date:   31 July 1998
Audience:   College/higher education ,  Professional and scholarly ,  Undergraduate ,  Postgraduate, Research & Scholarly
Format:   Hardback
Publisher's Status:   Active
Availability:   In Print  
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Table of Contents

1. Diabetes in the United States: epidemiology, scope and impact.- 2. Stages of diabetic nephropathy.- 3. Mesangial expansion in diabetic nephropathy: functional and genetic considerations.- 4. Nephropathy in NIDDM — an update.- 5. Clinical imperatives in diabetic nephropathy: the devastating impact of comorbidity.- 6. Dialysis in diabetic patients: three decades of experience, from 1964 to 1997.- 7. Hemodialysis in patients with diabetes mellitus.- 8. Continuous ambulatory peritoneal dialysis in 224 diabetics with end stage renal disease: evidence of improved survival over the past 10 years.- 9. The natural history and classification of diabetic retinopathy.- 10. Long-term visual outcome of diabetic patients treated with panretinal photocoagulation.- 11. A new hypothesis on mechanisms of retinal vascular permeability in diabetes.- 12. Angiogenesis in diabetic retinopathy: a history of accomplishment, discovery and promise.- 13. Surgical management of proliferative diabetic retinopathy.- 14. Heart disease in patients with the diabetic renal-retinal syndrome: clinical considerations.- 15. NO and diabetic complications.- 16. AGE and the kidney: an update.- 17. Xenotransplantation of encapsulated porcine islets.- 18. Generation of non-immunogenic islet cells using genetic engineering.- 19. Insulin-independence for > 10 years in 32 pancreas transplant recipients from a historical era.- 20. Giving up: discontinuation of dialysis.

Reviews

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)

'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)

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