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糖尿病肾病:来自改善全球肾脏病预后组织(KDIGO)的临床最新进展

Diabetic kidney disease: a clinical update from Kidney Disease: Improving Global Outcomes.

作者信息

Molitch Mark E, Adler Amanda I, Flyvbjerg Allan, Nelson Robert G, So Wing-Yee, Wanner Christoph, Kasiske Bertram L, Wheeler David C, de Zeeuw Dick, Mogensen Carl E

机构信息

Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Institute of Metabolic Science, Addenbrooke's Hospitals, Cambridge, UK.

出版信息

Kidney Int. 2015 Jan;87(1):20-30. doi: 10.1038/ki.2014.128. Epub 2014 Apr 30.

Abstract

The incidence and prevalence of diabetes mellitus (DM) continue to grow markedly throughout the world, due primarily to the increase in type 2 DM (T2DM). Although improvements in DM and hypertension management have reduced the proportion of diabetic individuals who develop chronic kidney disease (CKD) and progress to end-stage renal disease (ESRD), the sheer increase in people developing DM will have a major impact on dialysis and transplant needs. This KDIGO conference addressed a number of controversial areas in the management of DM patients with CKD, including aspects of screening for CKD with measurements of albuminuria and estimated glomerular filtration rate (eGFR); defining treatment outcomes; glycemic management in both those developing CKD and those with ESRD; hypertension goals and management, including blockers of the renin-angiotensin-aldosterone system; and lipid management.

摘要

糖尿病(DM)的发病率和患病率在全球范围内持续显著增长,主要原因是2型糖尿病(T2DM)的增加。尽管糖尿病和高血压管理的改善降低了发生慢性肾脏病(CKD)并进展至终末期肾病(ESRD)的糖尿病患者比例,但患糖尿病的人数急剧增加将对透析和移植需求产生重大影响。本次KDIGO会议讨论了糖尿病合并CKD患者管理中的一些争议领域,包括通过测量蛋白尿和估算肾小球滤过率(eGFR)筛查CKD的各个方面;定义治疗结果;CKD患者和ESRD患者的血糖管理;高血压目标和管理,包括肾素 - 血管紧张素 - 醛固酮系统阻滞剂;以及血脂管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c747/4214898/657aba2c8f99/nihms579947f1.jpg

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