الفهرس 
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Abstract
Diabetic nephropathy is the major cause of end-stage renal disease. Diabetic nephropathy is characterized by hypertension, progressive albuminuria, and decline in glomerular filtration rate (GFR) leading to ESRD. The first step in the screening and diagnosis of diabetic nephropathy is to measure albumin in urine sample.
Patients with nephropathy and type 1 diabetes almost always have other signs of diabetic microvascular disease, such as retinopathy and neuropathy. The relationship between diabetic nephropathy and retinopathy is less predictable in type 2 diabetes .
Proteinuria in diabetes mellitus is occasionally due to a glomerular disease other than diabetic nephropathy, or to nephrosclerosis. The major clinical clues suggesting nondiabetic glomerular disease include the onset of proteinuria less than five years from the documented onset of type 1 diabetes; the acute onset of renal disease; the presence of an active urine sediment containing red cells and cellular casts; signs and/or symptoms of another systemic disease; or significant reduction in the glomerular filtration rate (>30 percent) within two to three months of the administration of ACE inhibitors or angiotensin II receptor blockers.
The risk of progression of diabetic nephropathy has improved over the last several decades, largely due to rigorous glycemic control, more blood pressure reduction and the use of angiotensin converting enzyme inhibitors.
The Aim of Work is to study the prevalence of diabetic nephropathy among diabetic patients who attending El Mahalla General Hospital and the risk factors related to diabetic nephropathy .
In our study One hundred diabetic patients who attending El Mahalla general hospital clinic were included in this study.
Excluded patients who had:-
•urinary tract infection
•acute febrile illness
•vigorous exercise
•heart failure
•chronic renal failure
All patients were subjected to:- Questioner of Medical history included:
•Age
•duration of diabetes.
•Hypertension
•Smoking
•oral contraceptive intake
•family history
•diabetic micro –macro vascular complications
Physical examination and Laboratory evaluation included (ACR , HbA1C serum creatinine and calculated GFR).
The results of study showed that 78% of all studied patients had diabetic nephropathy. There were statistically significant relationships between nephrogenic diabetes and duration of diabetes , higher systemic blood pressures, significant fall in estimated glomerular filtration rate (eGFR) levels through the course of disease; poor glycemic control ,obesity and family history of diabetes.
There were no statistically significant relationships between nephrogenic diabetes, age of patient ,oral contraceptive pills,gander and smoking.