Boucek P
Klinika diabetologie a hepatogastroenterologie IKEM, Praha.
Cas Lek Cesk. 1997 Nov 19;136(22):689-92.
Diabetic nephropathy is one of the main causes of chronic renal failure in developed countries. The genesis and development of diabetic nephropathy is associated in both types of diabetes with a more rapid progression of other secondary complications and an increased mortality, in particular cardiovascular mortality. The main causes of development of diabetic nephropathy are prolonged hyperglycaemia along with a so far not elucidated inborn disposition. The course of diabetic nephropathy is characterized more clearly in type 1 diabetes. The clinically manifest stage is already irreversible and in the course of years it develops into chronic renal failure. Preventive and curative measures include maintenance of optimal metabolic control, systematic control of blood pressure, in particular by ACE-inhibitors, and a reduction of protein intake. Systematic multidisciplinary collaboration in care for patients with diabetic nephropathy helps to prevent the progression of other secondary complications such as diabetic foot and diabetic retinopathy. At present in the Czech Republic dialysis methods substituting renal function are available to practically all patients with diabetic nephropathy. As regards survival time and quality of life the optimal method of renal function replacement for patients in the terminal stage of diabetic nephropathy is transplantation.
糖尿病肾病是发达国家慢性肾衰竭的主要病因之一。糖尿病肾病的发生和发展在两种类型的糖尿病中都与其他继发性并发症的更快进展以及死亡率增加相关，尤其是心血管死亡率。糖尿病肾病发展的主要原因是长期高血糖以及迄今尚未阐明的先天易感性。1型糖尿病中糖尿病肾病的病程特征更为明显。临床显性阶段已经不可逆转，并且在数年的病程中会发展为慢性肾衰竭。预防和治疗措施包括维持最佳代谢控制、系统控制血压，特别是使用血管紧张素转换酶抑制剂，以及减少蛋白质摄入量。对糖尿病肾病患者进行系统的多学科协作护理有助于预防其他继发性并发症的进展，如糖尿病足和糖尿病视网膜病变。目前在捷克共和国，几乎所有糖尿病肾病患者都可以使用替代肾功能的透析方法。就生存时间和生活质量而言，糖尿病肾病终末期患者肾功能替代的最佳方法是肾移植。
