Baretić M, Lang V Bralić
Acta Med Croatica. 2016 Dec;70(4-5):269-74.
The management of hyperglycemia in patients with chronic kidney disease (CKD) is complex, and the goals and methods regarding glycemic control are not clearly defined. Although aggressive glycemic control seems to be advantageous in early diabetic nephropathy, outcome data supporting tight glycemic control in patients with advanced CKD are lacking. Challenges in the management of such patients include monitoring difficulties and the complexity of available treatments. In this article, we review the current treatment options for patients with diabetes and CKD discussing all hypoglycemic agents that currently are available, as well as insulin, along with their indications and contraindications. The aim is to provide useful information to family physicians when deciding on individualized glycemic goals and appropriate therapy for patients with early or end stages of CKD.
慢性肾脏病（CKD）患者的高血糖管理较为复杂，血糖控制的目标和方法尚不明确。尽管积极的血糖控制在早期糖尿病肾病中似乎具有优势，但缺乏支持晚期CKD患者严格血糖控制的结局数据。此类患者管理中的挑战包括监测困难和现有治疗的复杂性。在本文中，我们回顾了糖尿病合并CKD患者目前的治疗选择，讨论了所有目前可用的降糖药物以及胰岛素，及其适应证和禁忌证。目的是在为CKD早期或终末期患者确定个体化血糖目标和合适治疗方案时，为家庭医生提供有用信息。
