2010CARI 2型糖尿病患者中慢性腎臟病的預(yù)防
《2010CARI 2型糖尿病患者中慢性腎臟病的預(yù)防》內(nèi)容預(yù)覽
It should be noted that the best way to prevent CKD in individuals with diabetes is to prevent diabetes. NHMRC recommendations for the primary prevention of type 2 diabetes are available elsewhere (http://www. diabetesaustralia.com.au). These guidelines specifically target the management of individuals with established type 2 diabetes.
A risk factor analysis for kidney dysfunction in type 2 diabetes following 15 years of follow up from the UKPDS study,identified systolic blood pressure; urinary albumin excretion and plasma creatinine as common risk factors for albuminuria and kidney impairment (creatinine clearance and doubling of plasma creatinine). Additional independent risk factors for kidney impairment were female gender,decreased waist circumference, age, increased insulin sensi-tivity and sensory neuropathy. A cross-sectional study of 1003 Japanese hospital patients with type 2 diabetes identi-fied large waste circumference and elevated BP as risk factors for microalbuminuria while dyslipidaemia was identified as a risk factor for decreased glomerular Filtration Rate (GFR).
In contrast to type 1 diabetes, only 20% of newly diag-nosed people with type 2 diabetes are normotensive and have a normal circadian blood pressure profile. Therefore hypertension usually precedes the onset of microalbumin-uria.BP control modulates the progression not only of microangiopathy (diabetic kidney disease and retinopathy) but also of macroangiopathy (Coronary heart disease(CHD) and stroke).
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