Nephrology and Hypertension in Minnesota

Diabetic Nephropathy Clinic

The Diabetic Nephropathy Clinic in the Division of Nephrology and Hypertension at Mayo Clinic Rochester was created in 2004 to provide comprehensive diagnosis and treatment for patients with diabetic nephropathy, also known as diabetic kidney disease. This clinic brings together a dedicated group of nephrologists, hypertension nurses and dietitians who use a specialized treatment program developed at Mayo Clinic to customize therapy for each patient.

The Diabetic Nephropathy Clinic offers patients who have diabetes the opportunity for early screening to identify diabetic nephropathy and begin treatment to slow down disease progression. Frequently, patients may not know that they have diabetic nephropathy because they may exhibit no symptoms in the early stages of the disease. Because diabetic nephropathy can lead to increased risk for kidney failure and heart disease, medical evaluation is important to diagnose the condition promptly and to properly maintain kidney and heart function.

Physicians within the Diabetic Nephropathy Clinic work closely with specialists in the Division of Endocrinology and local physicians in coordinating treatment and follow-up care.

Goals of the Diabetic Nephropathy Clinic

• Early diagnosis of diabetic nephropathy using state-of-the-art diagnostic tools including blood tests, urinalysis, renal imaging, kidney biopsy and urologic evaluation.
• Appropriate treatment of diabetic nephropathy guided by a specialized treatment plan developed at Mayo Clinic to monitor progress and adjust therapy when needed.
• Research to increase understanding of the causes of diabetic nephropathy in order to advance and develop novel therapies for the disease. In 2007, the Diabetic Nephropathy Clinic completed a clinical trial testing the use of pirfenidone as a treatment for diabetic nephropathy. New trials evaluating treatment with sulodexide and vildagliptin are in development.

Treatment Plan for Diabetic Nephropathy Patients

Patients treated in the Diabetic Nephropathy Clinic receive a specialized treatment plan customized to their needs.

• Clinic physicians and nurses use medications to help manage and improve each patient's kidney function, hypertension (high blood pressure), blood sugar control, anemia and cholesterol level.
• Dietitians educate patients about nutrition and develop a specialized dietary plan to limit consumption of salt, protein, caffeine and alcohol.
• Nephrology nurse specialists counsel patients about making important lifestyle changes to maintain good health. Patients learn about smoking cessation treatment, exercise programs and weight management.
• Nephrologists and nurse specialists review current medications taken by each patient and help adjust dosage or change medication if necessary to improve the patient's kidney function and prevent medication side effects.
• Patients are also counseled to avoid medications that could cause further kidney damage. These medications include nonsteriodal anti-inflammatory drugs and iodine contrast agents which are used for angiogram studies and CT scans.
• When appropriate, patients are offered the opportunity to participate in clinical trials testing new therapies for diabetic nephropathy.

Research

Current research initiatives include:

• Clinical trials to develop novel therapies including studies to evaluate Pirfenidone, sulodexide and vildagliptin.
• Development of genetic tests to assist in the diagnosis of diabetic nephropathy
• Development of novel diagnostic tools for earlier diagnosis of diabetic nephropathy

Nephrologists from the Diabetic Nephropathy Clinic have recently completed subject recruitment for a multicenter trial, sponsored by the National Institutes of Health, which will further evaluate the use of pirefenidone in diabetic nephropathy treatment.

Researchers will also participate in an upcoming trial for sulodexide, another medication used in diabetic nephropathy treatment.

Appointments

Patients can request an appointment in Mayo Clinic's Division of Nephrology and Hypertension in Rochester. No physician referral is required.

For appointments or more information, call the Central Appointment Office at (507) 538-3270 7 a.m. to 7 p.m. Central time Monday through Thursday, 7 a.m. to 5 p.m. Friday.

Diabetic Nephropathy Clinic Staff

Physician Staff
Axel Pflueger, M.D., Ph.D.
Vincent Canzanello, M.D.

Registered Nurses
Jo Augustine
Nancy Driscoll
Pat Jensen
Carol Nash
Lois Penheiter
Genie Sprau
Mary Tibor

Dietitian
Janelle Gonyea
Nancy Kaufman

Study Coordinators
Shirley Jennison
Lori Riess