Current practices in the management of diabetic nephropathy
Current practices in the management of diabetic nephropathy
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DOI：
10.4997/jrcpe.2013.413
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发表时间：
2013-01-01
影响因子：
1.4
通讯作者：
Tang, S. C-W
中科院分区：
文献类型：
--
作者：
Chan, G.;Tang, S. C-W
治疗糖尿病（DM）患者的社会和经济负担正在迅速上升。目前的预测估计，全球糖尿病患者的患病率将从2010年的6.4%（2.85亿）上升到2030年的7.7%（4.39亿）。1这种疾病的主要问题是随着时间的推移，它倾向于发生大血管和微血管并发症，包括糖尿病肾病（DN）。糖尿病肾病影响约三分之一的糖尿病患者。它是全球终末期肾病（ESRD）的主要原因，占美国所有接受肾脏替代治疗（RRT）患者的42%。2.面对糖尿病患者人数的不可阻挡的增长，这一问题的严重性继续增长。寻找治疗方法来阻止这一潮流仍然是许多肾病学家的追求。DN的特征之一是尿蛋白排泄增加，长期以来，微量白蛋白尿被认为是这种疾病的早期表现。3，4蛋白尿和慢性肾脏疾病（CKD）是心血管疾病的重要决定因素，在很大程度上，DN患者的生存率由心血管疾病发病率决定。虽然目前还没有治愈的方法，但可以选择预防或减缓疾病进展的治疗方案。在这次更新中，我们的目标是解决目前的医疗设施在管理DN。
The social and economic burden of treating patients with diabetes mellitus (DM) is rapidly rising. Current projections estimate the global prevalence of individuals with DM to rise from 6.4% (285 million) in 2010 to 7.7% (439 million) in 2030.1 The main problem with this disease entity is its propensity to incur macro-and micro-vascular complications over time, including diabetic nephropathy (DN).Diabetic nephropathy affects approximately one-third of individuals with diabetes. It is the leading cause of end-stage renal disease (ESRD) worldwide, accounting for 42% of all patients on renal replacement therapy (RRT) in the United States. 2 The magnitude of this problem has continued to grow in the face of an inexorable rise in the number of diabetic patients. The search for therapeutic modalities to stem this tide remains the quest of many nephrologists. One of the hallmarks of DN is increased urinary protein excretion, and micro-albuminuria has long been proposed as an early manifestation of this disease. 3,4 Albuminuria and chronic kidney disease (CKD) are strong determinants of cardiovascular disease and to a large extent, the survival of patients with DN is determined by cardiovascular morbidity. Although there remains no cure at present, treatment options to prevent or slow disease progression are available. In this update, we aim to address the current armamentarium in the management of DN.