Assignment task:
A 56 y-o diabetic male is visiting your clinic for the first time after being referred from his primary care physician.? His urine dipstick at the previous routine clinic visit showed 1+ protein, and the patient now presents with questions regarding his renal disease.? He has had diabetes treated with metformin for the past 11 years.? He asks what causes kidney problems and diabetes.? You begin by saying the first step to diabetic nephropathy is
A- glycosylation of sugars
B- selective efferent arteriolar constriction mediated by Angiotensin II (hyperfiltration due to the presence of sugars in the blood) à glomerular hypertrophy à accumulation of glycosylated sugars in the mesangium à glomerular microalbuminuria à macroalbuminuria.
C-selective afferent arterial constriction
D- loss of podocyte charge barrier