Evaluation of renal function and renal risk in the twenty-first century


The global increase of obesity and type 2 diabetes (T2DM) has epidemic proportions. Worldwide, an estimated 2.16 billions subjects are overweight or obese and 382 million people have diabetes, a number that will rise to 592 million by 2035. This pandemic may portend severe consequences in Nephrology. Thus, an accurate evaluation of renal function and a proper identification of the risk of renal disease are both crucial in patients with diabetes and obesity. In this course we will discuss in detail the limitations of standard methods i.e. creatinine clearance and formulas in reflecting renal function. Several studies observed that estimated GFR does not properly reflect renal function in diabetes as well as in other clinical conditions. This portends severe consequences in clinical practice and research. Also, during the last decade, several new markers of renal disease in diabetic nephropathy have been described. We will discuss the relevance of novel markers of tubular damage, lipotoxicity, inflammation, microRNA among others in diabetic renal disease

Course content

    1. The role of glomerular hyperfiltration in diabetic nephropathy
    2. Obesity as a risk factor for renal disease.
    3. The bias of formulas in obesity, diabetes and chronic nephropathies.
    4. The importance of measured GFR in clinical research.
    5. Why formulas fail in reflecting GFR?
    6. How to evaluate agreement between estimated and measured GFR.
    7. New markers of renal disease in diabetes and obesity.
    8. Lipotoxicity: markers of fatty kidney.
    9. Tubular markers of renal disease
    10. Inflammation and diabetes.
    11. MicroRNA and renal disease