Bonner Ryan, Albajrami Oltjon, Hudspeth James, Upadhyay Ashish
Section of Nephrology, Department of Medicine, Boston Medical Center and Boston University School of Medicine, 800 Harrison Avenue, G009, Boston, MA 02118, USA.
Section of Nephrology, Department of Medicine, Boston Medical Center and Boston University School of Medicine, 800 Harrison Avenue, G009, Boston, MA 02118, USA.
Prim Care. 2020 Dec;47(4):645-659. doi: 10.1016/j.pop.2020.08.004. Epub 2020 Sep 23.
Diabetic kidney disease (DKD) is the most common cause of chronic kidney disease in the United States. Approximately 30% to 40% of individuals with diabetes mellitus develop DKD, and the presence of DKD significantly elevates the risk for morbidity and mortality. Understanding of DKD has grown in recent years. This review describes the pathogenesis of DKD and expands on evidence-based strategies for DKD management, integrating traditional approaches for hyperglycemia, hypertension, and albuminuria management with emerging therapeutic options. Given the public health burden of DKD, it is essential to prioritize prevention, recognition, and management of DKD in the primary care setting.
糖尿病肾病(DKD)是美国慢性肾病最常见的病因。约30%至40%的糖尿病患者会发展为DKD,而DKD的存在会显著增加发病和死亡风险。近年来,人们对DKD的认识有所提高。本综述描述了DKD的发病机制,并扩展了基于证据的DKD管理策略,将传统的高血糖、高血压和蛋白尿管理方法与新兴治疗选择相结合。鉴于DKD的公共卫生负担,在初级保健环境中对DKD的预防、识别和管理进行优先排序至关重要。