Friedman Eli A
Distinguished Teaching Professor of Medicine, Downstate Medical Center, Brooklyn, New York, USA.
Rambam Maimonides Med J. 2010 Jul 2;1(1):e0005. doi: 10.5041/RMMJ.10005. Print 2010 Jul.
The expanding impact of chronic kidney disease (CKD) due to pandemic diabetes mellitus is recounted emphasizing its epidemiology that has induced global socioeconomic stress on health care systems in industrialized nations now attempting to proffer optimal therapy for end stage renal disease (ESRD). Strategies to delay and perhaps prevent progression of diabetic nephropathy from minimal proteinuria through nephrotic range proteinuria and azotemia to ESRD appear to have decreased the rate of persons with diabetes who develop ESRD. For those with ESRD attributed to diabetes, kidney transplantation affords better survival and rehabilitation than either hemodialysis or peritoneal dialysis. It is likely that advances in genetics and molecular biology will suggest early interventions that will preempt diabetic complications including renal failure.
文中讲述了大流行的糖尿病所致慢性肾脏病（CKD）日益扩大的影响，强调了其流行病学情况，这已给工业化国家的医疗保健系统带来了全球社会经济压力，这些国家目前正试图为终末期肾病（ESRD）提供最佳治疗。从微量蛋白尿到肾病范围蛋白尿、氮质血症，再到ESRD，延缓甚至可能预防糖尿病肾病进展的策略似乎已降低了发生ESRD的糖尿病患者比例。对于因糖尿病导致ESRD的患者，肾移植比血液透析或腹膜透析能带来更好的生存和康复效果。遗传学和分子生物学的进展很可能会带来早期干预措施，从而预防包括肾衰竭在内的糖尿病并发症。
