Joven Mark Henry, Anderson Robert J
Endocrinology, Diabetes and Metabolism, Creighton University, 601 N. 30th Street, Suite 5766, Omaha, NE, 68131, USA,
Curr Diab Rep. 2015 Jul;15(7):44. doi: 10.1007/s11892-015-0613-6.
Diabetic nephropathy (DN) is associated with a high incidence of cardiovascular (CV) morbidity and mortality. Although relationships between hypertension and diabetic nephropathy are complex, blood pressure (BP) control is an important management strategy in the prevention of onset and progression of DN in patients with diabetes mellitus (DM). Recent guidelines recommend less stringent BP targets among patients with type 2 DM and chronic kidney disease. These recommendations are based mostly on lack of benefit in CV outcomes with a low BP target. We review the current information on efficacy of BP control in improving renal outcomes in patients with type 2 DM. Presently, although intensive BP control has been was beneficial in decreasing albuminuria, it has not translated into reductions in risks of hard renal endpoints, such as progression to end-stage renal disease, the need for renal replacement therapy, and mortality from renal causes.
糖尿病肾病（DN）与心血管（CV）疾病的高发病率和死亡率相关。尽管高血压与糖尿病肾病之间的关系复杂，但血压（BP）控制是预防糖尿病（DM）患者DN发生和进展的重要管理策略。最近的指南建议对2型糖尿病和慢性肾病患者采用不太严格的血压目标。这些建议主要基于较低血压目标在心血管结局方面缺乏益处。我们回顾了目前关于血压控制对改善2型糖尿病患者肾脏结局疗效的信息。目前，尽管强化血压控制有助于减少蛋白尿，但尚未转化为降低严重肾脏终点事件的风险，如进展为终末期肾病、需要肾脏替代治疗以及肾脏原因导致的死亡。
