Comprehensive risk management of diabetic kidney disease in patients with type 2 diabetes mellitus

被引：3
作者：
Araki S.-I. [1 ]
机构：
[1] Department of Medicine, Shiga University of Medical Science, Otsu, 520-2192, Shiga
来源：
Diabetology International | 2018年 / 9卷 / 2期
关键词：
Albuminuria; Comprehensive risk management; Diabetic kidney disease; Multifactorial intervention; Remission; Type 2 diabetes mellitus;
D O I：
10.1007/s13340-018-0351-5
中图分类号：
学科分类号：
摘要：
Diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus is a leading cause of end-stage renal disease worldwide. An increase in the severity of albuminuria and a decrease in the glomerular filtration rate, by which the DKD stages are categorized, are associated with higher risks of not only end-stage renal disease but also all-cause mortality and cardiovascular mortality. Thus, an optimal management strategy and adequate assessment of therapeutic success are of great clinical and societal relevance to improve the prognosis in patients with type 2 diabetes mellitus and DKD. At present, comprehensive risk management for glycemia, blood pressure, lipid profile, and lifestyle habits is emphasized with respect to cardio-renal protection, rather than one single risk management approach. However, the pharmacological therapy aiming at strict control of these risk factors may be associated with an increased risk of adverse effects, particularly in older adults with diabetes. Accordingly, in the clinical practice of diabetes care, we need to individualize the treatment goals for each risk factor according to the health and social status of each patient with type 2 diabetes mellitus and DKD. © 2018, The Japan Diabetes Society.
引用
收藏
页码：100 / 107
页数：7
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共 59 条
  • [1] Japanese Society for Dialysis Therapy. An overview of regular dialysis treatment in Japan. 2016
  • [2] Fox C.S., Matsushita K., Woodward M., Bilo H.J., Chalmers J., Heerspink H.J., Lee B.J., Perkins R.M., Rossing P., Sairenchi T., Tonelli M., Vassalotti J.A., Yamagishi K., Coresh J., de Jong P.E., Wen C.P., Nelson R.G., Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis, Lancet, 380, pp. 1662-1673, (2012)
  • [3] Wada T., Haneda M., Furuichi K., Babazono T., Yokoyama H., Iseki K., Araki S., Ninomiya T., Hara S., Suzuki Y., Iwano M., Kusano E., Moriya T., Satoh H., Nakamura H., Shimizu M., Toyama T., Hara A., Makino H., Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan, Clin Exp Nephrol., 18, pp. 613-620, (2014)
  • [4] Adler A.I., Stevens R.J., Manley S.E., Bilous R.W., Cull C.A., Holman R.R., Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64), Kidney Int, 63, pp. 225-232, (2003)
  • [5] K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification, Am J Kidney Dis, 39, pp. S1-S266, (2002)
  • [6] Kramer H.J., Nguyen Q.D., Curhan G., Hsu C.Y., Renal insufficiency in the absence of albuminuria and retinopathy among adults with type 2 diabetes mellitus, JAMA, 289, pp. 3273-3277, (2003)
  • [7] MacIsaac R.J., Tsalamandris C., Panagiotopoulos S., Smith T.J., McNeil K.J., Jerums G., Nonalbuminuric renal insufficiency in type 2 diabetes, Diabetes Care, 27, pp. 195-200, (2004)
  • [8] Yokoyama H., Araki S., Haneda M., Matsushima M., Kawai K., Hirao K., Oishi M., Sugimoto K., Sone H., Maegawa H., Kashiwagi A., Chronic kidney disease categories and renal-cardiovascular outcomes in type 2 diabetes without prevalent cardiovascular disease: a prospective cohort study (JDDM25), Diabetologia, 55, pp. 1911-1918, (2012)
  • [9] Afkarian M., Zelnick L.R., Hall Y.N., Heagerty P.J., Tuttle K., Weiss N.S., de Boer I.H., Clinical manifestations of kidney disease among US adults with diabetes, 1988–2014, JAMA, 316, pp. 602-610, (2016)
  • [10] Hidaka H., Terada M., Maegawa H., Kojima H., Koya D., Nishio Y., Haneda M., Yasuda H., Kashiwagi A., Kikkawa R., Evaluation of a new care system provided to diabetic patients in the outpatient clinic, Intern Med, 39, pp. 783-787, (2000)
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