Carella M J, Gossain V V, Rovner D R
Department of Medicine, Michigan State University, East Lansing.
Arch Intern Med. 1994 Mar 28;154(6):625-30.
Diabetic nephropathy affects approximately 35% of patients with insulin-dependent diabetes mellitus and about 5% to 10% of patients with non-insulin-dependent diabetes mellitus. Diabetic kidney disease can be detected early by special methods that measure microalbuminuria in the range of 15 to 140 micrograms/min or 0.02 to 0.20 g/d. Specific strategies have been proved beneficial in patients with this early diabetic kidney disease, also called "incipient nephropathy." Protein restriction, tight control of blood sugar and blood pressure, and specific therapy with angiotensin-converting enzyme inhibitors have been shown independently to reduce microalbuminuria and preserve renal function in these patients. We review the pathogenesis of diabetic kidney disease and discuss the effects of these treatment strategies on the renal, cardiovascular, metabolic, and other abnormalities found in early (incipient) and overt diabetic nephropathy.
糖尿病肾病影响约35%的胰岛素依赖型糖尿病患者以及约5%至10%的非胰岛素依赖型糖尿病患者。通过特殊方法可早期检测出糖尿病肾病，这些方法能测量出每分钟15至140微克或每日0.02至0.20克范围内的微量白蛋白尿。已证实特定策略对患有这种早期糖尿病肾病（也称为“初期肾病”）的患者有益。蛋白质限制、严格控制血糖和血压以及使用血管紧张素转换酶抑制剂进行特定治疗已分别显示可减少这些患者的微量白蛋白尿并保护肾功能。我们回顾糖尿病肾病的发病机制，并讨论这些治疗策略对早期（初期）和显性糖尿病肾病中发现的肾脏、心血管、代谢及其他异常情况的影响。
