Causes
- The cause of type 1 diabetes is unknown, but it is believed that people inherit a tendency to develop diabetes, and that viruses may be involved.
- This auto-immune disease results from the body's failure to produce insulin, the hormone that allows glucose to enter the cells of the body to provide fuel. This is the result of an autoimmune process in which the body's immune system attacks and destroys the insulin producing cells of the pancreas.
- When glucose cannot enter the cells, it builds up in the blood and the body's cells literally starve to death. People with type 1 diabetes must take daily insulin injections and regularly monitor their blood sugar levels.
Some known risk factors include:
- A family history. Anyone with a parent or sibling with type 1 diabetes has a slightly increased risk of developing the condition.
- Genetics. The presence of certain genes indicates an increased risk of developing type 1 diabetes. In some cases — usually through a clinical trial — genetic testing can be done to determine if someone who has a family history of type 1 diabetes is at increased risk of developing the condition.
- Geography. The incidence of type 1 diabetes tends to increase as you travel away from the equator. People living in Finland and Sardinia have the highest incidence of type 1 diabetes — about two to three times higher than rates in the United States and 400 times that of people living in Venezuela.
Possible risk factors for type 1 diabetes include:
- Viral exposure. Exposure to Epstein-Barr virus, coxsackievirus, mumps virus or cytomegalovirus may trigger the autoimmune destruction of the islet cells, or the virus may directly infect the islet cells.
- Low vitamin D levels. Research suggests that vitamin D may be protective against type 1 diabetes. However, early intake of cow's milk — a common source of vitamin D — has been linked to an increased risk of type 1 diabetes.
- Other dietary factors. Omega-3 fatty acids may offer some protection against type 1 diabetes. Drinking water that contains nitrates may increase the risk. Additionally, the timing of the introduction of cereal into a baby's diet may affect his or her risk of type 1 diabetes. One clinical trial found that between ages 3 and 7 months appears to be the optimal time for introducing cereal.
Nephrotic Syndrome
Causes
- Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.
- The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.
- This condition can also occur as a result of infection (such as strep throat, hepatitis, or mononucleosis), use of certain drugs, cancer, genetic disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis.
- It can accompany kidney disorders such as glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.
- Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. This disorder occurs slightly more often in males than females.
- There are many specific causes of nephrotic syndrome. These include kidney diseases such as minimal-change nephropathy, focal glomerulosclerosis, and membranous nephropathy. Nephrotic syndrome can also result from systemic diseases that affect other organs in addition to the kidneys, such as diabetes, amyloidosis, and lupus erythematosus
- Congenital and hereditary focal glomerulosclerosis may result from mutations of genes that code for podocyte proteins, including nephrin, podocin, or the cation channel 6 protein.
- Nephrotic syndrome can result from drugs of abuse, such as heroin.
- Nephrotic-range proteinuria occurring in the third trimester of pregnancy is the classical finding of preeclampsia. In that condition, also known as toxemia, there is hypertension as well. It may occur de novo or it may be superimposed on another chronic kidney disease. In the latter case, there will have been preexisting proteinuria that will have worsened during pregnancy.
- Medication can cause nephrotic syndrome. This includes the very infrequent occurrence of minimal-change nephropathy with NSAID use, and the occurrence of membranous nephropathy with the administration of gold and penicillamine, which are older drugs used for rheumatic diseases; there have also been reports of focal glomerulosclerosis in association with bisphosphonates. Although recognized, these associations have not yet been quantified.
Risk factors
- Medical conditions that can damage your kidneys. Certain diseases and conditions increase your risk of developing nephrotic syndrome, such as diabetes, lupus, amyloidosis, minimal change disease and other kidney diseases.
- Certain medications. Examples of medications that can cause nephrotic syndrome include nonsteroidal anti-inflammatory drugs and drugs used to fight infections.
- Certain infections. Examples of infections that increase the risk of nephrotic syndrome include HIV, hepatitis B, hepatitis C and malaria.
The following factors increase your chance of developing nephrotic syndrome. If you have any of these risk factors, tell your doctor.
- Kidney disease
- Diabetes
- Lupus
- Drug abuse
- Hepatitis B
- Hepatitis C
- Medication side effect
- Any condition that causes a weakening of the immune system such as:
- Diabetes
- Organ transplant
- Chemotherapy: the administration of medicines that kill cancer cells.
- AIDS
- Acute glomerulonephritis
- Interstitial nephritis
- Cancer
- Reflux nephropathy
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