Management of nephropathy in patients with type 2 diabetes
在有类型 2 糖尿病的病人的 nephropathy 的管理。作者机构：Chinese Univ Hong Kong Prince Wales Hosp Dept Med & Therapeut Div Clin Pharmacol Shatin Hong Kong Peoples R China
出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)
年 卷 期：2002年第115卷第1期
页 面：129-135页
核心收录：
主 题：type 2 diabetes · nephropathy · albuminuria · hypertension · renin-angiotensin system
摘 要：Purpose To review evidence-based management of nephropathy in patients with type 2 *** sources A literature search (MEDLINE 1966 to 2000) was performed using the key word diabetic nephropathy . Relevant book chapters were also *** selection Well-controlled, prospective landmark studies and expert review articles on diabetic nephropathy were *** extraction Data and conclusions from the selected articles that provide solid evidence to the optimal management of diabetic nephropathy were extracted and interpreted in light of our clinical research experience with many thousands of Hong Kong Chinese *** Hypertension, long diabetes duration, poor glycaemic control and central obesity are the most important risk factors. Microalbuminuria is a practical marker to predict overt nephropathy in type 2 diabetic patients. Risk factor modification, renal function monitoring and combined therapies are the current integrated approaches to manage patients with diabetic kidney disease. Optimal glycaemic control is the mainstay of treatment but effective antihypertensive therapy is also key to delaying the progression of diabetic nephropathy. Angiotensin-converting enzyme inhibitors and angiotensin Ⅱ receptor antagonists have important renoprotective actions independent of their blood pressure lowering actions. Conclusions Diabetic nephropathy is the leading cause of end-stage renal disease worldwide. Monitoring renal function and screening for microalbuminuria will allow the identification of patients with nephropathy at a very early stage for intervention. Tight glycaemic control and aggressive antihypertensive treatment as well as the use of renin-angiotensin system inhibitors should substantially delay the progression of nephropathy.
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