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蛋白尿在肾脏病学、糖尿病学中的意义以及作为心血管风险标志物的意义。

Interest of albuminuria in nephrology, diabetology and as a marker of cardiovascular risk.

作者信息

Souweine Jean-Sébastien, Corbel Alice, Rigothier Claire, Roque Charlotte Dumas de La, Hadjadj Samy, Cristol Jean-Paul, Combe Christian, Bigot-Corbel Edith, Beauvieux Marie-Christine

机构信息

Service de biochimie et hormonologie, Hôpital Lapeyronie, CHRU de Montpellier, Montpellier, France, PhyMedExp, Inserm, CNRS, Université Montpellier, Département de biochimie et hormonologie, CHU de Montpellier, Montpellier, France.

Service de néphrologie, Hôpital de Brabois, CHU de Nancy, Vandoeuvre-lès-Nancy, France.

出版信息

Ann Biol Clin (Paris). 2019 Feb 1;77(1):26-35. doi: 10.1684/abc.2018.1402.

Abstract

Albuminuria is associated with the progression of chronic kidney disease and the occurrence of cardiovascular events in patients with and without diabetes. The evolution of albuminuria appears to be associated with patient's prognosis. How exactly microalbuminuria is linked to cardiovascular risk remains unclear. This association is probably explained by endothelial dysfunction or chronic low-grade inflammation. Albuminuria/creatininuria ratio allows reduction of potential errors in urine collection. In France, the recommendations for the monitoring of albuminuria depend on the cause of albuminuria. An increase in urinary albumin excretion could signify the need for an intensive multifactorial intervention strategy and albuminuria is a relevant biological marker to monitor therapeutic effectiveness, since a reduction of albuminuria in patients, irrespective of their diabetic status, predicts reduction of cardiovascular risk.

摘要

蛋白尿与慢性肾脏病的进展以及糖尿病患者和非糖尿病患者心血管事件的发生相关。蛋白尿的演变似乎与患者的预后相关。微量白蛋白尿究竟如何与心血管风险相关尚不清楚。这种关联可能是由内皮功能障碍或慢性低度炎症所解释。白蛋白尿/肌酐尿比值可减少尿液收集过程中的潜在误差。在法国,蛋白尿监测的建议取决于蛋白尿的病因。尿白蛋白排泄增加可能意味着需要采取强化多因素干预策略,并且蛋白尿是监测治疗效果的一个相关生物学标志物,因为无论患者的糖尿病状态如何,其蛋白尿减少都预示着心血管风险降低。

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