Martínez-Castelao Alberto, Navarro-González Juan F, Górriz José Luis, de Alvaro Fernando
Bellvitge´s University Hospital, Carlos III Research Institute, Barcelona 08907, Spain.
Candelarias's University Hospital, Carlos III Research Institute, Tenerife 38010, Spain.
J Clin Med. 2015 May 28;4(6):1207-16. doi: 10.3390/jcm4061207.
Diabetes Mellitus (DM) is a growing worldwide epidemic. It was estimated that more than 366 million people would be affected. DM has spread its presence over the world due to lifestyle changes, increasing obesity and ethnicities, among others. Diabetic nephropathy (DN) is one of the most important DM complications. A changing concept has been introduced from the classical DN to diabetic chronic kidney disease (DCKD), taking into account that histological kidney lesions may vary from the nodular or diffuse glomerulosclerosis to tubulointerstitial and/or vascular lesions. Recent data showed how primary and secondary prevention were the key to reduce cardiovascular episodes and improve life expectancy in diabetic patients. A stabilization in the rate of end stage kidney disease has been observed in some countries, probably due to the increased awareness by primary care physicians about the prognostic importance of chronic kidney disease (CKD), better control of blood pressure and glycaemia and the implementation of protocols and clinical practice recommendations about the detection, prevention and treatment of CKD in a coordinated and multidisciplinary management of the DM patient. Early detection of DM and DCKD is crucial to reduce morbidity, mortality and the social and economic impact of DM burden in this population.
糖尿病（DM）是一种在全球范围内日益流行的疾病。据估计，受影响的人数将超过3.66亿。由于生活方式的改变、肥胖率上升以及种族差异等因素，糖尿病已在全球蔓延。糖尿病肾病（DN）是糖尿病最重要的并发症之一。考虑到肾脏组织学病变可能从结节性或弥漫性肾小球硬化到肾小管间质和/或血管病变不等，已从经典的糖尿病肾病引入了一个不断变化的概念，即糖尿病慢性肾脏病（DCKD）。最近的数据表明，一级和二级预防是减少糖尿病患者心血管事件和提高预期寿命的关键。在一些国家，终末期肾病的发病率已趋于稳定，这可能是由于初级保健医生对慢性肾脏病（CKD）预后重要性的认识提高、血压和血糖得到更好控制，以及在糖尿病患者的协调多学科管理中实施了关于CKD检测、预防和治疗的方案及临床实践建议。早期发现糖尿病和糖尿病慢性肾脏病对于降低该人群中糖尿病负担的发病率、死亡率以及社会和经济影响至关重要。
