Division of Endocrinology, Diabetes and Metabolism (ARG) and Division of Nephrology (BMW, EOG), Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; and Veterans Affairs Medical Center (BMW), Memphis, Tennessee.
Am J Med Sci. 2014 May;347(5):406-13. doi: 10.1097/MAJ.0000000000000185.
Diabetic kidney disease (DKD) is the most common cause of chronic kidney disease in the United States. In the last several years, there have been several new developments in the field of the DKD. In 2007, the National Kidney Foundation and Kidney Disease Outcomes Quality Initiative released clinical practice guidelines that included new definitions and summarized diagnostic and therapeutic approaches for DKD. The results of several recent randomized controlled trials provided novel insights regarding effects of glycemic and lipid control on vascular and renal outcomes in patients with diabetes. Additionally, the findings of the Action to Control Cardiovascular Risk in Diabetes-Blood Pressure trial played a critical role in the revision of blood pressure target guidelines in patients with diabetes. The goal of this review article is to summarize recent updates and recommendations for the diagnosis and treatment of DKD.
糖尿病肾病(DKD)是美国最常见的慢性肾脏病病因。在过去几年中,DKD 领域有了一些新的进展。2007 年,美国国家肾脏基金会和肾脏病预后质量倡议发布了临床实践指南,其中包括了 DKD 的新定义,并总结了 DKD 的诊断和治疗方法。最近几项随机对照试验的结果为糖尿病患者的血糖和血脂控制对血管和肾脏结局的影响提供了新的见解。此外,心血管风险控制行动-糖尿病-血压试验的结果在修订糖尿病患者的血压目标指南中发挥了关键作用。本文的目的是总结 DKD 的诊断和治疗的最新进展和建议。