Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA.
Curr Diab Rep. 2013 Aug;13(4):550-9. doi: 10.1007/s11892-013-0381-0.
Diabetic kidney disease causes significant morbidity and mortality among people with type 1 diabetes (T1D). Intensive glucose and blood pressure control have thus far failed to adequately curb this problem and therefore a major need for novel treatment approaches exists. Multiple observations link serum uric acid levels to kidney disease development and progression in diabetes and strongly argue that uric acid lowering should be tested as one such novel intervention. A pilot of such a trial, using allopurinol, is currently being conducted by the Preventing Early Renal Function Loss (PERL) Consortium. Although the PERL trial targets T1D individuals at highest risk of kidney function decline, the use of allopurinol as a renoprotective agent may also be relevant to a larger segment of the population with diabetes. As allopurinol is inexpensive and safe, it could be cost-effective even for relatively low-risk patients, pending the completion of appropriate trials at earlier stages.
糖尿病肾病在 1 型糖尿病（T1D）患者中导致了大量的发病率和死亡率。迄今为止，强化血糖和血压控制未能充分遏制这一问题，因此迫切需要新的治疗方法。多项观察结果将血清尿酸水平与糖尿病患者的肾脏疾病发展和进展联系起来，并强烈表明应将降低尿酸作为一种新的干预措施进行测试。目前，预防早期肾功能丧失（PERL）联盟正在进行一项使用别嘌醇的此类试验的试点研究。尽管 PERL 试验针对的是 T1D 患者中肾功能下降风险最高的个体，但别嘌醇作为一种肾脏保护剂的使用也可能与糖尿病患者中的更大一部分人群相关。由于别嘌醇价格低廉且安全，即使对于风险相对较低的患者，在适当的早期试验完成之前，也可能具有成本效益。
