Explain how diabetes mellitus could cause kidney failure?

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  • Diabetes also damages the capillaries. Diabetic nephropathy(The earliest detectable change in the course of diabetic nephropathy is a thickening in the glomerulus), the impact of diabetes on the kidneys, can lead to scarring changes in the kidney tissue, loss of small or progressively larger amounts of protein in the urine, and eventually chronic kidney disease requiring dialysis.

    Glomerulosclerosis refers to a hardening of the glomerulus in the kidney. It is a general term to describe scarring of the kidneys’ tiny blood vessels, the glomeruli, the functional units in the kidney that filter urine from the blood.

    When the glucose concentration in the blood is raised to about 9-10 mmol/L (except certain conditions, such as pregnancy), beyond its renal threshold (i.e. when glucose level surpasses the transport maximum of glucose reabsorption), reabsorption of glucose in the proximal renal tubuli is incomplete, and part of the glucose remains in the urine (glycosuria). This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. This leads to overwork of the kidenys.

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