Central Michigan University, College of Medicine, Dept of Medicine, 1000 Houghton Ave, Saginaw, MI 48602, USA.
dQ&A Diabetes Research, 804 Haight Street, San Francisco, CA 94117, USA.
Clin Geriatr Med. 2020 Aug;36(3):431-445. doi: 10.1016/j.cger.2020.04.004. Epub 2020 Apr 17.
Diabetes and diabetic nephropathy have become more prevalent in the elderly population. Diabetic nephropathy has become increasingly prevalent in the elderly population. The presence of this disease in an age group suffering multiple comorbidities has altered the pathophysiology and leading cause of mortality. Mortality has become linked more often to cardiovascular events rather than progression of end-stage-renal-disease, which explains the recent shift of focus of trials to improving cardiovascular-outcomes in patients with diabetes. In this chapter, we emphasize the difference in treatment modalities and goals of therapy in elderly versus young. In addition, we discuss results from recent outcome trials with regards to renal benefits of sodium-glucose co-transporter-2-inhibitors and glucagon-like peptide-1-receptor-agonists.
糖尿病和糖尿病肾病在老年人群中变得更为普遍。老年人群中糖尿病肾病的患病率不断上升。这种疾病在患有多种合并症的年龄组中出现,改变了病理生理学和导致死亡的主要原因。死亡率越来越多地与心血管事件相关,而不是终末期肾病的进展,这解释了最近临床试验的重点转向改善糖尿病患者的心血管预后。在本章中,我们强调了老年患者与年轻患者在治疗方式和治疗目标上的差异。此外,我们还讨论了最近与钠-葡萄糖共转运蛋白 2 抑制剂和胰高血糖素样肽-1 受体激动剂的肾脏获益相关的结果试验。