Bojunga Jörg, Mondorf Antonia
Medizinische Klinik I, Universitätsklinikum Frankfurt am Main.
Dtsch Med Wochenschr. 2019 Aug;144(15):1044-1050. doi: 10.1055/a-0654-0783. Epub 2019 Jul 26.
Chronic kidney disease (CKD) is a common complication of diabetes mellitus and besides vascular nephropathy the most common cause of kidney failure (CKD G5). Along with an increase of the prevalence of diabetes the number of patients with diabetes and CKD will rise. General knowledge of the interactions between diabetes and CKD are essential for a safe and effective therapy. Appropriate glycemic control in patients with diabetes is important to prevent progression of CKD and hereby improve cardiovascular complications, quality of life and reduce mortality. However, many antidiabetics need to be dose-adjusted in CKD or should not be used in existing or progressive CKD, especially in patients with CKD G5, whereas insulin therapy is suitable for patients undergoing dialysis. However, some orally administered glucose-lowering agents can be safely used in these patients. This review provides an overview of the use and goals of diabetes therapy in the presence of CKD.
慢性肾脏病（CKD）是糖尿病常见的并发症，除血管性肾病外，还是肾衰竭（CKD G5）最常见的病因。随着糖尿病患病率的增加，糖尿病合并CKD的患者数量将会上升。了解糖尿病与CKD之间相互作用的一般知识对于安全有效的治疗至关重要。糖尿病患者进行适当的血糖控制对于预防CKD进展、改善心血管并发症、提高生活质量及降低死亡率非常重要。然而，许多抗糖尿病药物在CKD患者中需要调整剂量，或者在已有CKD或CKD进展的患者中不应使用，尤其是CKD G5的患者，而胰岛素治疗适用于接受透析的患者。不过，一些口服降糖药可在这些患者中安全使用。本综述概述了CKD患者糖尿病治疗的应用及目标。
