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糖尿病肾病的策略性研究:概念模型与临床表现述评。

A Strategic Investigation on Diabetic Nephropathy; Its Conceptual Model and clinical Manifestations: A Review.

机构信息

Department of Pharmacy, Pranveer Singh Institute of Technology, Kanpur, India.

Department of Pharmacy, Bharat Institute of Technology, Uttar Pradesh, India.

出版信息

Curr Diabetes Rev. 2023;19(5):e260422204036. doi: 10.2174/1573399818666220426091238.

Abstract

Diabetes is a major health issue, and its complications can lead to various health problems. Nephropathy has been recognised since the 1930s, when Kimmelstiel and Wilson first reported the characteristic nodular glomerulosclerosis lesions in diabetic kidneys. Diabetic nephropathy (DN), commonly known as diabetic kidney disease, is a condition in which people with diabetes have excessive quantities of urine albumin excretion, diabetic glomerular lesions, and a reduction in their glomerular filtration rate (GFR). Type 1 diabetes (autoimmune -cell destruction and absolute insulin insufficiency), type 2 diabetes (relative insulin deficit and resistance), and others are the three forms of diabetes (e.g., pancreatic disease). Diabetes nephropathy is the leading cause of chronic kidney disease and end-stage renal failure worldwide. Much research has been conducted in both basic science and clinical therapies to enhance the understanding of the mechanism of diabetic nephropathy and expand available therapeutics. Diabetic nephropathy prevention continues to rely on screening for microalbuminuria and treating hyperglycemia. However, several studies suggest that managing diabetic kidney disease is more challenging. Despite comparable hyperglycemic management, some studies suggest that the incidence of renal problems varies by patient. As a result, there has been a great deal of interest in studying the inherent renal protective effects of various antihyperglycemic drugs. This study aims to provide information about the diabetic kidney disease conceptual model, pathogenesis, screening, and diagnosis. It will also address the treatment and prevention of diabetic nephropathy, focusing on comparing the mechanisms, safety profiles, and efficacy of different antihyperglycemic medications.

摘要

糖尿病是一个主要的健康问题,其并发症可导致各种健康问题。自 20 世纪 30 年代以来,Kimmelstiel 和 Wilson 首次报道了糖尿病肾脏中特征性的结节性肾小球硬化病变,肾病就已经被认识到了。糖尿病肾病(DN),通常称为糖尿病肾病,是一种在糖尿病患者中出现大量尿白蛋白排泄、糖尿病肾小球病变和肾小球滤过率(GFR)降低的情况。1 型糖尿病(自身免疫细胞破坏和绝对胰岛素缺乏)、2 型糖尿病(相对胰岛素不足和抵抗)和其他形式的糖尿病(如胰腺疾病)是糖尿病的三种形式。糖尿病肾病是全球慢性肾脏病和终末期肾衰竭的主要原因。为了更好地了解糖尿病肾病的发病机制和扩大现有治疗方法,基础科学和临床治疗都进行了大量的研究。糖尿病肾病的预防仍然依赖于对微量白蛋白尿的筛查和对高血糖的治疗。然而,几项研究表明,治疗糖尿病肾病更具挑战性。尽管血糖控制相当,但一些研究表明,肾脏问题的发生率因患者而异。因此,人们对研究各种降血糖药物的固有肾脏保护作用产生了极大的兴趣。本研究旨在提供有关糖尿病肾病概念模型、发病机制、筛查和诊断的信息。它还将讨论糖尿病肾病的治疗和预防,重点比较不同降糖药物的机制、安全性概况和疗效。

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