Patschan D, Müller G A
Clinic of Nephrology and Rheumatology, University Hospital of Göttingen, Göttingen, Germany.
Int J Nephrol. 2016;2016:6232909. doi: 10.1155/2016/6232909. Epub 2016 Nov 15.
Diabetes mellitus (DM) significantly increases the overall morbidity and mortality, particularly by elevating the cardiovascular risk. The kidneys are severely affected as well, partly as a result of intrarenal athero- and arteriosclerosis but also due to noninflammatory glomerular damage (diabetic nephropathy). DM is the most frequent cause of end-stage renal disease in our society. Acute kidney injury (AKI) remains a clinical and prognostic problem of fundamental importance since incidences have been increased in recent years while mortality has not substantially been improved. As a matter of fact, not many studies particularly addressed the topic "AKI in diabetes mellitus." Aim of this article is to summarize AKI epidemiology and outcomes in DM and current recommendations on blood glucose control in the intensive care unit with regard to the risk for acquiring AKI, and finally several aspects related to postischemic microvasculopathy in AKI of diabetic patients shall be discussed. We intend to deal with this relevant topic, last but not least with regard to increasing incidences and prevalences of both disorders, AKI and DM.
糖尿病(DM)显著增加了总体发病率和死亡率,尤其是通过提高心血管风险。肾脏也会受到严重影响,部分原因是肾内动脉粥样硬化和动脉硬化,也由于非炎症性肾小球损伤(糖尿病肾病)。在我们的社会中,DM是终末期肾病最常见的原因。急性肾损伤(AKI)仍然是一个具有根本重要性的临床和预后问题,因为近年来发病率有所增加,而死亡率并未得到实质性改善。事实上,没有多少研究特别关注“糖尿病中的AKI”这一主题。本文的目的是总结DM中AKI的流行病学和结局,以及重症监护病房中关于血糖控制的当前建议,这些建议涉及发生AKI的风险,最后将讨论糖尿病患者AKI中与缺血后微血管病变相关的几个方面。我们打算处理这个相关主题,尤其是考虑到AKI和DM这两种疾病的发病率和患病率不断上升。