Montero Nuria, Oliveras Laia, Martínez-Castelao Alberto, Gorriz José Luis, Soler María José, Fernández-Fernández Beatriz, Quero Maria, García-Carro Clara, Garcia-Sancho Paula, Goicoechea Marian, Gorgojo Martínez Juan Jose, Molina Pablo, Puchades María Jesús, Rodríguez-Espinosa Diana, Sablón Nery, Santamaría Rafael, Navarro-González Juan Francisco
Department of Nephrology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Department of Nephrology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Nefrologia (Engl Ed). 2025 Apr;45 Suppl 1:1-26. doi: 10.1016/j.nefroe.2025.04.005.
To address all the changes in the management of people with diabetes (DM) and chronic kidney disease (CKD), under the auspices of the Spanish Society of Nephrology (SEN), the Spanish Diabetic Nephropathy Study Group (GEENDIAB) decided to publish an updated Clinical Practice Guideline for detection and management of diabetic kidney disease (DKD). It is aimed at a wide audience of clinicians treating diabetes and CKD. The terminology of kidney disease in diabetic patients has evolved toward a more inclusive nomenclature that avoids underdiagnosis of this entity. Thus, the terms "diabetes and kidney disease" and "diabetic kidney disease" are those proposed in the latest KDIGO 2022 guidelines to designate the whole spectrum of patients who can benefit from a comprehensive therapeutic approach only differentiated according to eGFR range and albuminuria. Recommendations have been divided into five main areas of interest: Chapter 1: Screening and diagnosis of diabetic kidney disease, Chapter 2: Metabolic control in people with diabetes and CKD, Chapter 3: Blood pressure control in people with diabetic kidney disease, Chapter 4: Treatment targeting progression of CKD in people with diabetic kidney disease, and Chapter 5: Antiplatelet or anticoagulant therapy in people with diabetes and CKD. World Health Organization (WHO) recommendations for guideline development were followed to report this guideline. Systematic reviews were carried out, with outcome ratings and summaries of findings, and we reported the strength of recommendations following the "Grading of Recommendations Assessment, Development and Evaluation" GRADE evidence profiles.
为应对糖尿病(DM)和慢性肾脏病(CKD)患者管理方面的所有变化,在西班牙肾脏病学会(SEN)的支持下,西班牙糖尿病肾病研究组(GEENDIAB)决定发布一份关于糖尿病肾病(DKD)检测与管理的更新版临床实践指南。该指南面向治疗糖尿病和CKD的广大临床医生群体。糖尿病患者肾脏疾病的术语已朝着更具包容性的命名发展,以避免对该疾病实体的诊断不足。因此,“糖尿病与肾脏疾病”和“糖尿病肾病”这两个术语是最新的KDIGO 2022指南中提出的,用于指代所有能从仅根据估算肾小球滤过率(eGFR)范围和蛋白尿进行区分的综合治疗方法中获益的患者群体。建议分为五个主要关注领域:第1章:糖尿病肾病的筛查与诊断;第2章:糖尿病和CKD患者的代谢控制;第3章:糖尿病肾病患者的血压控制;第4章:糖尿病肾病患者延缓CKD进展的治疗;第5章:糖尿病和CKD患者的抗血小板或抗凝治疗。本指南遵循世界卫生组织(WHO)的指南制定建议进行报告。进行了系统评价,并给出了结果评级和研究结果总结,我们按照“推荐分级评估、制定与评价”(GRADE)证据概要报告了推荐强度。