A. Trainees should acquire a general understanding of current
concepts of the pathophysiology of diabetic glomerulosclerosis
(DGS):
1. Epidemiology and course of nephropathy in IDDM
and NIDDM.
2. Pathophysiologic mechanisms and histologic
manifestations of DN
3. Strategies for prevention of DN
4. Therapy of established DN.
5. Modalities of therapy for ESRD in DN, inducing
hemo and peritoneal dialysis, kidney transplantation,
and kidney pancreas transplantation.
B. Trainees should develop an in-depth knowledge of:
1. The various ways in which DM may affect the
kidneys and urinary tract.
2. The cardinal clinical and histological features, as well
as the epidemiology and course of DGS in patients
with IDDM and NIDDM.
3. The results of clinical trials designed to prevent DN
or slow its progression.
4. The relative merits of different modalities of therapy
for ESRD in diabetic patients, including hemo- and
peritoneal dialysis, kidney transplantation, and kidney-
pancreas transplantation.
C. Trainees should be familiar with:
1. The definition, interpretation, prognostic value and
clinical use of “micro-albuminuria”.
2. Unique medical and surgical problems facing patients
with advanced DN as well as their management.
A. Trainees must have experience in the evaluation and management
of patients with progressive diabetic nephropathy both
insulin-dependent and non-insulin dependent. Experience with
treatment of blood pressure, fluid-electrolyte disorders, glycemia,
and non-renal diabetic complication is needed.
B. Trainees must have experience in the evaluation and management
of patients with end-stage diabetic nephropathy receiving hemo-
dialysis and peritoneal dialysis.
C. Trainees must have experience with the evaluation of patients with
diabetic nephropathy for renal transplantation.
D. Trainees must have experience managing patients with diabetic
nephropathy during and after renal transplantation.
