Pathogenesis of diabetic nephropathy
Pathogenesis of diabetic nephropathy
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DOI：
10.1023/b:remd.0000032412.91984.ec
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发表时间：
2004-08-01
影响因子：
8.2
通讯作者：
Berl, T
中科院分区：
文献类型：
--
作者：
van Dijk, C;Berl, T
糖尿病（DM）是美国（US）和其他发达国家种族和族裔群体中终末期肾病（ESRD）的最常见原因。根据最新的USRDS报告，糖尿病肾病（DMN）占美国ESRD新发病例的44%，在黑人、美洲原住民和西班牙裔人群中的发病率远远高于白人。糖尿病肾病（DMN）的发病率继续以远高于任何其他ESRD主要诊断的发病率的速度上升，这是由于糖尿病（主要是2型糖尿病（T2DM））患病率增加的结果[1]。根据2002年的数据报告，共有131，173例DMN患者需要肾脏替代治疗：其中77%接受血液透析，6.2%接受腹膜透析，16.1%接受移植。ESRD与高死亡率相关，其中DMN患者的死亡率最高。在一项大型队列研究中，与非糖尿病患者相比，糖尿病透析患者的校正相对死亡风险为1.69 [2]。这些患者透析前阶段的高死亡率可能低估了糖尿病肾病诊断的不良进展[3]。
Diabetes Mellitus (DM) is the most common cause of end-stage renal disease (ESRD) across racial and ethnic groups in the United States (US) and other developed countries. According to most recent USRDS reports, diabetic nephropathy (DMN) represents 44% of new cases of ESRD in the United States and accounts for far higher rates in black, Native American and Hispanic populations than it does in whites. The incidence of diabetic nephropathy (DMN) continues to rise far more rapidly than rates due to any other primary diagnosis of ESRD as a result of the increasing prevalence of DM, predominantly those with type 2 diabetes (T2DM)[1]. A total of 131,173 patients with DMN were requiring renal replacement therapy: 77% of these were on hemodialysis, 6.2% are on peritoneal dialysis and 16.1% are transplant recipients according to the 2002 data report.ESRD is associated with high mortality rates, and among these, those with DMN have the highest rates. Adjusted relative risk of death in diabetic dialysis patients compared to their non-diabetic counterparts was 1.69 in a large cohort study [2]. The high mortality rates in the predialysis period in these patients may underestimate the poor progression that the diagnosis of diabetic nephropathy imparts [3].