الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SUMMARY
M results from lack or reduced effectiveness of endogenous insulin. Hyperglycaemia is one aspect of far –reaching metabolic derangement, which causes serious micro-vascular (retinopathy, nephropathy, neuropathy) or macrovascular problems; stroke, renovascular disease, limb ischaemia - and above all heart disease So think of DM as avascular disease when meeting adiabetic person adopt aholistic approach consider other cardiovascular risk factors too – they tend to cluster together.
347 million people worldwide have diabetes. In 2012, diabetes was the direct cause of 1.5 million deaths. More than 80%of diabetes deaths occur in low-and middle –income countries. WHO projects that diabetes will be the 7th leading cause of death in 2030. Healthy diet regular physical activity maintaining a normal body weight and avoid or delay the onset of type 2 diabetes.
Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus, as well as the leading cause of renal failure worldwide). It occurs in approximately one-third of all patients with diabetes and is independently correlated with an increased risk of end-stage renal disease. The prognosis of DN has been poor due to diagnosis at an advanced stage and the high rate of recurrence. Although significant efforts have been made to develop novel diagnostic and therapeutic approaches, DN remains a severe condition with high rates of morbidity and mortality.
D
Summary
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Accordingly, the early diagnosis of DN is critical to prevent the long-term damaging effects of kidney loss in patients with diabetes.
Tumor necrosis factor-α (TNF-α) is a proinflammatory cytokine that is essential in the regulation of inflammation, apoptosis and oxidative stress in the kidney. A high level of urinary TNF-α is correlated with renal injury and a disruption of the glomerular permeability barrier in patients with diabetes. This indicates that TNF-α is causally linked to renal injury in patients with diabetes and