Schröder W, Heyl W
Universitäts-Frauenklinik für Gynäkologie und Geburtshilfe, RWTH Aachen.
Z Geburtshilfe Neonatol. 1997 May-Jun;201(3):75-81.
With a percentage of 20% diabetic nephropathy represents one of the most common causes of end-stage renal failure. During pregnancy it is associated with an increased perinatal morbidity as a striking result of the consistently high rate of 50% preterm deliveries mainly due to the frequent development of pre-eclampsia ranging between 35-55%. Perinatal mortality (0-11%) seems to be less increased in recent years. Simple and reliable screening methods by means of test-strips are available in order to detect microalbuminuria, which characterizes incipient diabetic nephropathy (stage III). Strict maternal metabolic control achieving normoglycemic blood glucose levels represents the basic of treatment. Furthermore, an adequate diet and control of blood pressure are fundamental issues of sufficient therapy. Currently, there are no data available to assess definitely the influence of pregnancy on the clinical course of diabetic nephropathy.
糖尿病肾病占终末期肾衰竭最常见病因的20%。孕期糖尿病肾病与围产期发病率增加相关,这是一个显著的结果,主要由于子痫前期发生率持续高达50%,导致早产率一直居高不下,在35%至55%之间。近年来围产期死亡率(0%至11%)似乎增加较少。有简单可靠的试纸检测方法可用于检测微量白蛋白尿,微量白蛋白尿是早期糖尿病肾病(III期)的特征。严格控制母体代谢,使血糖水平达到正常血糖水平是治疗的基础。此外,适当的饮食和血压控制是充分治疗的基本问题。目前,尚无数据可确切评估妊娠对糖尿病肾病临床病程的影响。