Gäckler D, Jäkel S, Fricke L, Reinsch B, Fischer F
Praxis für Nierenerkrankungen und Diabetes Bochum.
Dtsch Med Wochenschr. 2013 May;138(18):949-55. doi: 10.1055/s-0032-1332992. Epub 2013 Apr 23.
Diabetic nephropathy is the leading cause of end-stage renal disease all over the world. Diagnosis is confirmed by measuring urin albumin excretion and calculated renal function (eGFR). Once the diagnosis is confirmed there should be a search for confounding cardiovascular risk factors and even established cardiovascular disease because of the associated high cardiovascular risk. In type 1 diabetes metabolic control is the main issue. In case of renal impairment and in patients with type 2 diabetes a multifactorial approach is necessary, which consists of dietary advise, metabolic control, lowering elevated blood-pressure, cessation of smoking, ASS and lipid-lowering drug-therapy. Special drugs for the treatment of diabetes-induced renal disease are not available.
糖尿病肾病是全球终末期肾病的主要病因。通过测量尿白蛋白排泄量和计算肾功能（估算肾小球滤过率）来确诊。一旦确诊，由于其相关的高心血管风险，应寻找混杂的心血管危险因素，甚至已确诊的心血管疾病。在1型糖尿病中，代谢控制是主要问题。在肾功能损害的情况下以及2型糖尿病患者中，需要采取多因素方法，包括饮食建议、代谢控制、降低血压、戒烟、抗血小板治疗和降脂药物治疗。目前尚无治疗糖尿病所致肾病的特效药物。
