Nadolnik Klaudia, Skrypnik Damian, Skrypnik Katarzyna, Bogdański Pawe
Faculty of Medicine I, Poznan University of Medical Sciences, Poznan, Poland
Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego 82/84, 60-569 Poznan, Poland
Rocz Panstw Zakl Hig. 2018;69(4):327-334. doi: 10.32394/rpzh.2018.0037.
Common health problems of the elderly in the near future will become even more common with aging of the population and longer average life expectancy. The elderly tend to have multiple disorders at one time, some of which may aggravate the course of others. One of the most common diseases, diabetes – “the epidemics of XXI century”, treatment of which costs approximately 11% of world health care budget – is the leading reason of chronic kidney disease and end-stage renal disease. Diabetic nephropathy can be a complication of both diabetes mellitus type 1 and 2. The most numerous group of patients with recently-made diagnosis are these above 60 years of age. Albuminuria, which, depending on its intensity, is one of the diagnostic criteria, can appear even in the process of aging itself. Overlapping of structural and functional changes that develop with age and those caused by diabetes is therefore a challenge, both diagnostic and clinical. There are certain methods of early diagnosis and prevention of progression of diabetic kidney disease. There is, however, no targeted treatment and existing therapies are generally based on glycemia and blood pressure control. Some patients in the advanced stage undergo dialyses just like in other kidney failure cases. The course of the disease is influenced by modifiable factors, such as protein and salt intake or cigarette smoking. In the light of the fact that this problem will concern an increasing number of patients, diagnostics and treatment can and should be introduced in the early stages of the disease. This all fits within the recently popular “healthy aging” ideology. Its popularization and implementation can bring measurable benefits of social and economic character.
随着人口老龄化和平均预期寿命延长，老年人常见的健康问题在不久的将来会变得更加普遍。老年人往往同时患有多种疾病，其中一些疾病可能会加重其他疾病的病程。最常见的疾病之一——糖尿病，即“21世纪的流行病”，其治疗费用约占全球医疗保健预算的11%，是慢性肾脏病和终末期肾病的主要原因。糖尿病肾病可能是1型和2型糖尿病的并发症。最近确诊的患者中人数最多的群体是60岁以上的人群。蛋白尿根据其严重程度是诊断标准之一，甚至可能在衰老过程中出现。因此，衰老过程中发生的结构和功能变化与糖尿病引起的变化相互重叠，这在诊断和临床方面都是一个挑战。有一些早期诊断和预防糖尿病肾病进展的方法。然而，目前没有针对性的治疗方法，现有的治疗通常基于血糖和血压控制。一些晚期患者像其他肾衰竭病例一样接受透析治疗。疾病的病程受可改变因素的影响，如蛋白质和盐的摄入量或吸烟。鉴于这个问题将涉及越来越多的患者，诊断和治疗可以而且应该在疾病的早期阶段进行。这一切都符合最近流行的“健康老龄化”理念。其推广和实施可以带来可衡量的社会和经济效益。
