Classification and Differential Diagnosis of Diabetic Nephropathy.
Classification and Differential Diagnosis of Diabetic Nephropathy.
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DOI：
10.1155/2017/8637138
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发表时间：
2017
影响因子：
4.3
通讯作者：
Wu H
中科院分区：
文献类型：
--
作者：
Qi C;Mao X;Zhang Z;Wu H
糖尿病肾病（DN）是全世界发达国家和发展中国家终末期肾病的主要原因。本文简要介绍了DN的特征性病理改变和Tervaert病理分类，Tervaert病理分类根据肾小球病变将DN分为四种类型，并对肾小管、间质和血管病变分别采用沿着评分系统。鉴于糖尿病肾病的异质性和复杂的发病机制，Tervaert分型在指导诊断和预后方面既有意义，也有争议。本文根据近年来的研究，对肾活检Tervaert分型的应用和评价以及肾活检的适应证进行了综述。同时，本文还讨论了与另一种结节性肾小球病的鉴别诊断以及典型DN叠加非糖尿病肾病（NDRD）的情况。
Diabetic nephropathy (DN) is a major cause of end-stage renal disease throughout the world in both developed and developing countries. This review briefly introduces the characteristic pathological changes of DN and Tervaert pathological classification, which divides DN into four classifications according to glomerular lesions, along with a separate scoring system for tubular, interstitial, and vascular lesions. Given the heterogeneity of the renal lesions and the complex mechanism underlying diabetic nephropathy, Tervaert classification has both significance and controversies in the guidance of diagnosis and prognosis. Applications and evaluations using Tervaert classification and indications for renal biopsy are summarized in this review according to recent studies. Meanwhile, differential diagnosis with another nodular glomerulopathy and the situation that a typical DN superimposed with a nondiabetic renal disease (NDRD) are discussed and concluded in this review.