A Diachronic Study of Diabetic Nephropathy in Two Autochthonous Lines of Rats to Understand Diabetic Chronic Complications

The worldwide epidemic of Type 2 Diabetes Mellitus, a result of recent deep changes in human lifestyle like sedentary and overly rich nutrition, has dramatic consequences in terms of morbidity, mortality and health care costs (Zimmet et al., 2001). Type 2 Diabetes Mellitus is a complex and multifactorial metabolic disorder which includes distinct nosological entities whose common patterns are hyperglycaemia, resistance to insulin and progressive chronic complications (American Diabetic Association, 2009). A significant proportion of patients will develop a clinically relevant diabetic nephropathy with glomerulopathy, hyalinization of afferent and efferent arterioles, tubular and interstitial lesions (Fioretto et al., 2008). Nephropathy is a very serious complication in both Type 1 and Type 2 Diabetes Mellitus because patients with diabetic kidney disease are at a higher risk of mortality, mostly from cardiovascular complications, than diabetic patients without diabetic nephropathy (Dronavalli & Barkis, 2008). In the Western World the incidence of end-stage renal failure associated to the burden of diabetic nephropathy has increased in recent years and represents a failure of current disease control measure with serious public health implications (Stewart et al, 2006; Villar & Zaoui, 2010). In Latin America, where incidence of Type 2 Diabetes Mellitus is on the rise and has reached epidemic proportions, people usually have poor disease control with the consequence of very high rates of diabetic nephropathy (Caballero & Tenzer, 2007). A study performed in the Asian Pacific region has also shown that diabetic nephropathy was the most common cause of End-Stage Renal Disease in 9 of the 12 countries surveyed and 6 of the 12 countries had greater than 35% of their dialysis patients age 60 years and older (Lee, 2003). In United States, between 20% and 40% of patients ultimately develop diabetic nephropathy, the most common cause of End-Stage Renal Disease requiring dialysis (Dronavalli & Barkis, 2008). Since 2000, the adjusted rate of prevalent End-Stage Renal Disease cases in the United States population ages 65–74, has increased 25 % with an enormous economic impact on the healthcare systems (United States Renal Data System, 2010). In sum, worldwide incidence of diabetic nephropathy, a frequently silent and unrecognized disease, has increased about a 50% between 1998 and 2008 and is now the leading cause of chronic kidney disease and End-Stage Renal Disease (Unites States Renal