糖尿病肾病的最新进展
Recent advances in diabetic nephropathy.
作者信息
Marshall S M
机构信息
School of Clinical Medical Sciences, 4th Floor, William Leech Building, The Medical School, Framlington Place, Newcastle upon Tyne NE2 4HH, UK.
出版信息
Postgrad Med J. 2004 Nov;80(949):624-33. doi: 10.1136/pgmj.2004.021287.
Abstract
Diabetic nephropathy is the leading cause of end stage renal disease worldwide and is associated with increased cardiovascular risk. The earliest clinical manifestation is of microalbuminuria. Tight blood glucose and blood pressure control reduce the risk of microalbuminuria. Once microalbuminuria is present, the rate of progression to end stage renal disease and of cardiovascular disease can be delayed by aggressive management of blood pressure, glucose, and lipids. Inhibition of the renin-angiotensin system is important to reduce intraglomerular pressure but other classes of antihypertensive agent may also be needed to gain adequate control of systemic blood pressure. Such measures can at least half the rate of progression of nephropathy and cardiovascular disease.
摘要
糖尿病肾病是全球终末期肾病的主要病因，且与心血管风险增加相关。最早的临床表现是微量白蛋白尿。严格控制血糖和血压可降低微量白蛋白尿的风险。一旦出现微量白蛋白尿，通过积极控制血压、血糖和血脂，可延缓进展至终末期肾病和心血管疾病的速度。抑制肾素-血管紧张素系统对于降低肾小球内压力很重要，但可能还需要其他种类的抗高血压药物来充分控制全身血压。这些措施至少可使肾病和心血管疾病的进展速度减半。
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