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
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
相关论文
共 59 条
[21]  
Lewis E.J., Hunsicker L.G., Clarke W.R., Berl T., Pohl M.A., Lewis J.B., Ritz E., Atkins R.C., Rohde I., Raz R., Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes, N Engl J Med, 345, pp. 851-860, (2001)
[22]  
Brenner B.M., Cooper M.E., de Zeeuw D., Keane W.F., Mitch W.E., Parving H.H., Remuzzi G., Snapinn S.M., Zhang Z., Shahinfar S., Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy, N Engl J Med, 345, pp. 861-869, (2001)
[23]  
Parving H.H., Lehnert H., Brochner-Mortensen J., Gomis R., Andersen S., Arner P., The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes, N Engl J Med, 345, pp. 870-878, (2001)
[24]  
Gaede P., Vedel P., Larsen N., Jensen G.V., Parving H.-H., Pedersen O., Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes, N Engl J Med, 348, pp. 383-393, (2003)
[25]  
Gaede P., Lund-Andersen H., Parving H.-H., Pedersen O., Effect of a multifactorial intervention on mortality in type 2 diabetes, N Engl J Med, 358, pp. 580-591, (2008)
[26]  
Gaede P., Oellgaard J., Carstensen B., Rossing P., Lund-Andersen H., Parving H.H., Pedersen O., Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial, Diabetologia, 59, pp. 2298-2307, (2016)
[27]  
Oellgaard J., Gaede P., Rossing P., Persson F., Parving H.H., Pedersen O., Intensified multifactorial intervention in type 2 diabetics with microalbuminuria leads to long-term renal benefits, Kidney Int, 91, pp. 982-988, (2017)
[28]  
Joss N., Ferguson C., Brown C., Deighan C.J., Paterson K.R., Boulton-Jones J.M., Intensified treatment of patients with type 2 diabetes mellitus and overt nephropathy, QJM., 97, pp. 219-227, (2004)
[29]  
Tu S.T., Chang S.J., Chen J.F., Tien K.J., Hsiao J.Y., Chen H.C., Hsieh M.C., Prevention of diabetic nephropathy by tight target control in an asian population with type 2 diabetes mellitus: a 4-year prospective analysis, Arch Intern Med, 170, pp. 155-161, (2010)
[30]  
Sandbaek A., Griffin S.J., Sharp S.J., Simmons R.K., Borch-Johnsen K., Rutten G.E., van den Donk M., Wareham N.J., Lauritzen T., Davies M.J., Khunti K., Effect of early multifactorial therapy compared with routine care on microvascular outcomes at 5 years in people with screen-detected diabetes: a randomized controlled trial: the ADDITION-Europe Study, Diabetes Care, 37, pp. 2015-2023, (2014)