[1]中华医学会糖尿病学分会微血管并发症学组.中国糖尿病肾脏病防治指南(2021年版)[J].国际内分泌代谢杂志,2021,41(04):388-410.[doi:10.3760/cma.j.cn121383-20210825-08064]
 Microvascular Complications Group of Chinese Diabetes Society.Clinical guideline for the prevention and treatment of diabetic kidney disease in China(2021 edition)[J].International Journal of Endocrinology and Metabolism,2021,41(04):388-410.[doi:10.3760/cma.j.cn121383-20210825-08064]
点击复制

中国糖尿病肾脏病防治指南(2021年版)()
分享到:

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
41
期数:
2021年04期
页码:
388-410
栏目:
指南与共识
出版日期:
2021-07-20

文章信息/Info

Title:
Clinical guideline for the prevention and treatment of diabetic kidney disease in China(2021 edition)
作者:
中华医学会糖尿病学分会微血管并发症学组
Author(s):
Microvascular Complications Group of Chinese Diabetes Society
关键词:
糖尿病肾脏病 筛查 诊断 治疗
DOI:
10.3760/cma.j.cn121383-20210825-08064
摘要:
近年来,国内外糖尿病肾脏病(DKD)的研究取得了许多重要进展,获得了更多循证医学证据。中华医学会糖尿病学分会微血管并发症学组组织全国内分泌及肾脏病领域相关专家编写了该指南,旨在传递最新及重要进展,进一步规范DKD的管理。指南内容涵盖DKD的定义、筛查、诊断、分期、评估及防治。突出早期筛查,强调规范化综合管理的重要性,注重新型抗高血糖药物在DKD治疗中的作用; 强调“诊断-分期-评估-防治”的一体化诊疗模式,并制定诊疗流程图,突出临床实用性。指南将有助于临床医师对DKD患者进行规范化管理,并致力于改善DKD患者的预后。

参考文献/References:

[1] Atkins D,Best D,Briss PA,et al.Grading quality of evidence and strength of recommendations[J].BMJ,2004,328(7454):1490.DOI:10.1136/bmj.328.7454.1490.
[2] Li Y,Teng D,Shi X,et al.Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association:national cross sectional study[J].BMJ,2020,369:m997.DOI:10.1136/bmj.m997.
[3] Cheng HT,Xu X,Lim PS,et al.Worldwide epidemiology of diabetes-related end-stage renal disease,2000-2015[J].Diabetes Care,2021,44(1):89-97.DOI:10.2337/dc20-1913.
[4] Afkarian M,Zelnick LR,Hall YN,et al.Clinical manifestations of kidney disease among US adults with diabetes,1988-2014[J].JAMA,2016,316(6):602-610.DOI:10.1001/jama.2016.10924.
[5] de Boer IH,Rue TC,Hall YN,et al.Temporal trends in the prevalence of diabetic kidney disease in the United States[J].JAMA,2011,305(24):2532-2539.DOI:10.1001/jama.2011.861.
[6] Zhang XX,Kong J,Yun K.Prevalence of diabetic nephropathy among patients with type 2 diabetes mellitus in China:a Meta analysis of observational studies[J].J Diabetes Res,2020,2020:2315607.DOI:10.1155/2020/2315607.
[7] KDOQI.KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease[J].Am J Kidney Dis,2007,49(2 Suppl 2):S12-S154.DOI:10.1053/j.ajkd.2006.12.005.
[8] Tuttle KR,Bakris GL,Bilous RW,et al.Diabetic kidney disease:a report from an ADA Consensus Conference[J].Diabetes Care,2014,37(10):2864-2883.DOI:10.2337/dc14-1296.
[9] American Diabetes Association.(9)Microvascular complications and foot care[J].Diabetes Care,2015,38 Suppl:S58-66.DOI:10.2337/dc15-S012.
[10] Kidney Disease:Improving Global Outcomes(KDIGO)Diabetes Work Group.KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease[J].Kidney Int,2020,98(4S):S1-S115.DOI:10.1016/j.kint.2020.06.019.
[11] Vallon V,Platt KA,Cunard R,et al.SGLT2 mediates glucose reabsorption in the early proximal tubule [J].J Am Soc Nephrol,2011,22(1):104-112.DOI:10.1681/ASN.2010030246.
[12] Molitch ME,DeFronzo RA,Franz MJ,et al.Nephropathy in diabetes[J].Diabetes Care,2004,27 Suppl 1:S79-S83.DOI:10.2337/diacare.27.2007.s79.
[13] Adler AI,Stevens RJ,Manley SE,et al.Development and progression of nephropathy in type 2 diabetes:the United Kingdom Prospective Diabetes Study(UKPDS 64)[J].Kidney Int,2003,63(1):225-232.DOI:10.1046/j.1523-1755.2003.00712.x.
[14] Wu Y,Wang Y,Zhang J,et al.Early-onset of type 2 diabetes mellitus is a risk factor for diabetic nephropathy progression:a biopsy-based study[J].Aging(Albany NY),2021,13(6):8146-8154.DOI:10.18632/aging.202624.
[15] Wu B,Zhang S,Lin H,et al.Prevention of renal failure in Chinese patients with newly diagnosed type 2 diabetes:a cost-effectiveness analysis[J].J Diabetes Investig,2018,9(1):152-161.DOI:10.1111/jdi.12653.
[16] American Diabetes Association.11.Microvascular complications and foot care:standards of medical care in diabetes-2021[J].Diabetes Care,2021,44 Suppl 1:S151-S167.DOI:10.2337/dc21-S011.
[17] Jun M,Ohkuma T,Zoungas S,et al.Changes in albuminuria and the risk of major clinical outcomes in diabetes:results from ADVANCE-ON[J].Diabetes Care,2018,41(1):163-170.DOI:10.2337/dc17-1467.
[18] Ohkuma T,Jun M,Chalmers J,et al.Combination of changes in estimated GFR and albuminuria and the risk of major clinical outcomes[J].Clin J Am Soc Nephrol,2019,14(6):862-872.DOI:10.2215/CJN.13391118.
[19] Parving HH,Brenner BM,McMurray JJ,et al.Cardiorenal end points in a trial of aliskiren for type 2 diabetes[J].N Engl J Med,2012,367(23):2204-2213.DOI:10.1056/NEJMoa1208799.
[20] Coresh J,Heerspink H,Sang Y,et al.Change in albuminuria and subsequent risk of end-stage kidney disease:an individual participant-level consortium meta-analysis of observational studies[J].Lancet Diabetes Endocrinol,2019,7(2):115-127.DOI:10.1016/S2213-8587(18)30313-9.
[21] Lee E,Collier CP,White CA.Interlaboratory variability in plasma creatinine measurement and the relation with estimated glomerular filtration rate and chronic kidney disease diagnosis[J].Clin J Am Soc Nephrol,2017,12(1):29-37.DOI:10.2215/CJN.05400516.
[22] 万倩,张倩,钱毅,等.肾小球滤过率评估方程在2型糖尿病患者中的应用[J].中国糖尿病杂志,2014,22(9):799-803.DOI:10.3969/j.issn.1006-6187.2014.09.009.
[23] Lu J,Mu Y,Su Q,et al.Reduced kidney function is associated with cardiometabolic risk factors,prevalent and predicted risk of cardiovascular disease in Chinese adults:results from the REACTION study[J].J Am Heart Assoc,2016,5(7):e003328.DOI:10.1161/JAHA.116.003328.
[24] Inker LA,Schmid CH,Tighiouart H,et al.Estimating glomerular filtration rate from serum creatinine and cystatin C[J].N Engl J Med,2012,367(1):20-29.DOI:10.1056/NEJMoa1114248.
[25] Chi XH,Li GP,Wang QS,et al.CKD-EPI creatinine-cystatin C glomerular filtration rate estimation equation seems more suitable for Chinese patients with chronic kidney disease than other equations[J].BMC Nephrol,2017,18(1):226.DOI:10.1186/s12882-017-0637-z.
[26] Xie D,Shi H,Xie J,et al.A validation study on eGFR equations in Chinese patients with diabetic or non-diabetic CKD[J].Front Endocrinol(Lausanne),2019,10:581.DOI:10.3389/fendo.2019.00581.
[27] Fufaa GD,Weil EJ,Nelson RG,et al.Association of urinary KIM-1,L-FABP,NAG and NGAL with incident end-stage renal disease and mortality in American Indians with type 2 diabetes mellitus[J].Diabetologia,2015,58(1):188-198.DOI:10.1007/s00125-014-3389-3.
[28] Satirapoj B,Pooluea P,Nata N,et al.Urinary biomarkers of tubular injury to predict renal progression and end stage renal disease in type 2 diabetes mellitus with advanced nephropathy:a prospective cohort study[J].J Diabetes Complications,2019,33(9):675-681.DOI:10.1016/j.jdiacomp.2019.05.013.
[29] Molitch ME,Steffes M,Sun W,et al.Development and progression of renal insufficiency with and without albuminuria in adults with type 1 diabetes in the diabetes control and complications trial and the epidemiology of diabetes interventions and complications study[J].Diabetes Care,2010,33(7):1536-1543.DOI:10.2337/dc09-1098.
[30] Penno G,Russo E,Garofolo M,et al.Evidence for two distinct phenotypes of chronic kidney disease in individuals with type 1 diabetes mellitus[J].Diabetologia,2017,60(6):1102-1113.DOI:10.1007/s00125-017-4251-1.
[31] Yokoyama H,Sone H,Oishi M,et al.Prevalence of albuminuria and renal insufficiency and associated clinical factors in type 2 diabetes:the Japan Diabetes Clinical Data Management study(JDDM15)[J].Nephrol Dial Transplant,2009,24(4):1212-1219.DOI:10.1093/ndt/gfn603.
[32] Thomas MC,Macisaac RJ,Jerums G,et al.Nonalbuminuric renal impairment in type 2 diabetic patients and in the general population(national evaluation of the frequency of renal impairment cO-existing with NIDDM [NEFRON] 11)[J].Diabetes Care,2009,32(8):1497-1502.DOI:10.2337/dc08-2186.
[33] Penno G,Solini A,Bonora E,et al.Clinical significance of nonalbuminuric renal impairment in type 2 diabetes[J].J Hypertens,2011,29(9):1802-1809.DOI:10.1097/HJH.0b013e3283495cd6.
[34] 杜瑞琴,张毅,李全民,等.正常白蛋白尿的2型糖尿病肾病患者临床特点调查[J].中华糖尿病杂志,2017,9(8):494-498.DOI:10.3760/cma.j.issn.1674-5809.2017.08.006.
[35] Buyadaa O,Magliano DJ,Salim A,et al.Risk of rapid kidney function decline,all-cause mortality,and major cardiovascular events in nonalbuminuric chronic kidney disease in type 2 diabetes[J].Diabetes Care,2020,43(1):122-129.DOI:10.2337/dc19-1438.
[36] Yamanouchi M,Mori M,Hoshino J,et al.Retinopathy progression and the risk of end-stage kidney disease:results from a longitudinal Japanese Cohort of 232 patients with type 2 diabetes and biopsy-proven diabetic kidney disease[J].BMJ Open Diabetes Res Care,2019,7(1):e000726.DOI:10.1136/bmjdrc-2019-000726.
[37] He F,Xia X,Wu XF,et al.Diabetic retinopathy in predicting diabetic nephropathy in patients with type 2 diabetes and renal disease:a meta-analysis[J].Diabetologia,2013,56(3):457-466.DOI:10.1007/s00125-012-2796-6.
[38] Wang J,Han Q,Zhao L,et al.Identification of clinical predictors of diabetic nephropathy and non-diabetic renal disease in Chinese patients with type 2 diabetes,with reference to disease course and outcome[J].Acta Diabetol,2019,56(8):939-946.DOI:10.1007/s00592-019-01324-7.
[39] Tong X,Yu Q,Ankawi G,et al.Insights into the role of renal biopsy in patients with T2DM:a literature review of global renal biopsy results[J].Diabetes Ther,2020,11(9):1983-1999.DOI:10.1007/s13300-020-00888-w.
[40] Tervaert TW,Mooyaart AL,Amann K,et al.Pathologic classification of diabetic nephropathy[J].J Am Soc Nephrol,2010,21(4):556-563.DOI:10.1681/ASN.2010010010.
[41] Vallon V,Thomson SC.The tubular hypothesis of nephron filtration and diabetic kidney disease[J].Nat Rev Nephrol,2020,16(6):317-336.DOI:10.1038/s41581-020-0256-y.
[42] Mise K,Hoshino J,Ueno T,et al.Prognostic value of tubulointerstitial lesions,urinary N-Acetyl-β-d-glucosaminidase,and urinary β2-microglobulin in patients with type 2 diabetes and biopsy-proven diabetic nephropathy[J].Clin J Am Soc Nephrol,2016,11(4):593-601.DOI:10.2215/CJN.04980515.
[43] Hoshino J,Furuichi K,Yamanouchi M,et al.A new pathological scoring system by the Japanese classification to predict renal outcome in diabetic nephropathy[J].PLoS One,2018,13(2):e0190923.DOI:10.1371/journal.pone.0190923.
[44] Stevens PE,Levin A.Evaluation and management of chronic kidney disease:synopsis of the kidney disease:improving global outcomes 2012 clinical practice guideline[J].Ann Intern Med,2013,158(11):825-830.DOI:10.7326/0003-4819-158-11-201306040-00007.
[45] Inker LA,Grams ME,Levey AS,et al.Relationship of estimated GFR and albuminuria to concurrent laboratory abnormalities:an individual participant data Meta-analysis in a global consortium[J].Am J Kidney Dis,2019,73(2):206-217.DOI:10.1053/j.ajkd.2018.08.013.
[46] Bragg F,Holmes MV,Iona A,et al.Association between diabetes and cause-specific mortality in rural and urban areas of China[J].JAMA,2017,317(3):280-289.DOI:10.1001/jama.2016.19720.
[47] Fox CS,Matsushita K,Woodward M,et al.Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes:a meta-analysis[J].Lancet,2012,380(9854):1662-1673.DOI:10.1016/S0140-6736(12)61350-6.
[48] Zhao Z,Huo L,Wang L,et al.Survival of Chinese people with type 2 diabetes and diabetic kidney disease:a Cohort of 12-year follow-up[J].BMC Public Health,2019,19(1):1498.DOI:10.1186/s12889-019-7859-x.
[49] Afkarian M,Sachs MC,Kestenbaum B,et al.Kidney disease and increased mortality risk in type 2 diabetes[J].J Am Soc Nephrol,2013,24(2):302-308.DOI:10.1681/ASN.2012070718.
[50] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,4(13):315-409.DOI:10.3760/cma.j.cn115791-20210223-00100.
[51] 中国心血管病风险评估和管理指南编写联合委员会.中国心血管病风险评估和管理指南[J].中华预防医学杂志,2019,53(1):13-35.DOI:10.3760/cma.j.issn.0253-9624.2019.01.004.
[52] de Zeeuw D,Remuzzi G,Parving HH,et al.Albuminuria,a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy[J].Circulation,2004,110(8):921-927.DOI:10.1161/01.CIR.0000139860.33974.28.
[53] Oshima M,Neuen BL,Li J,et al.Early change in albuminuria with canagliflozin predicts kidney and cardiovascular outcomes:a post hoc analysis from the CREDENCE trial[J].J Am Soc Nephrol,2020,31(12):2925-2936.DOI:10.1681/ASN.2020050723.
[54] Menne J,Ritz E,Ruilope LM,et al.The Randomized Olmesartan and Diabetes Microalbuminuria Prevention(ROADMAP)observational follow-up study:benefits of RAS blockade with olmesartan treatment are sustained after study discontinuation[J].J Am Heart Assoc,2014,3(2):e000810.DOI:10.1161/jaha.114.000810.
[55] Cabrera CS,Lee AS,Olsson M,et al.Impact of CKD progression on cardiovascular disease risk in a contemporary UK cohort of individuals with diabetes[J].Kidney Int Rep,2020,5(10):1651-1660.DOI:10.1016/j.ekir.2020.07.029.
[56] Maqbool M,Cooper ME,Jandeleit-Dahm K.Cardiovascular disease and diabetic kidney disease[J].Semin Nephrol,2018,38(3):217-232.DOI:10.1016/j.semnephrol.2018.02.003.
[57] Yokoyama H,Araki SI,Kawai K,et al.The prognosis of patients with type 2 diabetes and nonalbuminuric diabetic kidney disease is not always poor:implication of the effects of coexisting macrovascular complications(JDDM 54)[J].Diabetes Care,2020,43(5):1102-1110.DOI:10.2337/dc19-2049.
[58] Thorn LM,Gordin D,Harjutsalo V,et al.The presence and consequence of nonalbuminuric chronic kidney disease in patients with type 1 diabetes[J].Diabetes Care,2015,38(11):2128-2133.DOI:10.2337/dc15-0641.
[59] Penno G,Solini A,Orsi E,et al.Non-albuminuric renal impairment is a strong predictor of mortality in individuals with type 2 diabetes:the Renal Insufficiency And Cardiovascular Events(RIACE)Italian multicentre study[J].Diabetologia,2018,61(11):2277-2289.DOI:10.1007/s00125-018-4691-2.
[60] So WY,Kong AP,Ma RC,et al.Glomerular filtration rate,cardiorenal end points,and all-cause mortality in type 2 diabetic patients[J].Diabetes Care,2006,29(9):2046-2052.DOI:10.2337/dc06-0248.
[61] Umanath K,Lewis JB.Update on diabetic nephropathy:core curriculum 2018[J].Am J Kidney Dis,2018,71(6):884-895.DOI:10.1053/j.ajkd.2017.10.026.
[62] 血液透析年发病率和病因构成[J].中国血液净化,2012,11(z1):6-9.
[63] Narres M,Claessen H,Droste S,et al.The incidence of end-stage renal disease in the diabetic(compared to the non-diabetic)population:a systematic review[J].PLoS One,2016,11(1):e0147329.DOI:10.1371/journal.pone.0147329.
[64] Yang XL,So WY,Kong AP,et al.Modified end-stage renal disease risk score for Chinese type 2 diabetic patients--the Hong Kong Diabetes Registry[J].Diabetologia,2007,50(6):1348-1350.DOI:10.1007/s00125-007-0639-7.
[65] Liao LN,Li CI,Liu CS,et al.Extreme levels of HbA1c increase incident ESRD risk in Chinese patients with type 2 diabetes:competing risk analysis in National Cohort of Taiwan Diabetes Study[J].PLoS One,2015,10(6):e0130828.DOI:10.1371/journal.pone.0130828.
[66] Liu D,Lv LL.New Understanding on the role of proteinuria in progression of chronic kidney disease[J].Adv Exp Med Biol,2019,1165:487-500.DOI:10.1007/978-981-13-8871-2_24.
[67] Jia Y,Zheng Z,Xue M,et al.Extracellular vesicles from albumin-induced tubular epithelial cells promote the M1 macrophage phenotype by targeting klotho[J].Mol Ther,2019,27(8):1452-1466.DOI:10.1016/j.ymthe.2019.05.019.
[68] Skupien J,Warram JH,Smiles AM,et al.The early decline in renal function in patients with type 1 diabetes and proteinuria predicts the risk of end-stage renal disease[J].Kidney Int,2012,82(5):589-597.DOI:10.1038/ki.2012.189.
[69] Jiang G,Luk A,Tam C,et al.Progression of diabetic kidney disease and trajectory of kidney function decline in Chinese patients with type 2 diabetes[J].Kidney Int,2019,95(1):178-187.DOI:10.1016/j.kint.2018.08.026.
[70] Chapter 2:Definition,identification,and prediction of CKD progression[J].Kidney Int Suppl(2011),2013,3(1):63-72.DOI:10.1038/kisup.2012.65.
[71] 张倩,万倩,孙丹,等.2型糖尿病患者肾小球滤过率降低的危险因素及临床意义的研究[J].中国糖尿病杂志,2015,23(8):702-705.DOI:10.3969/j.issn.1006-6187.2015.08.002.
[72] Coresh J,Turin TC,Matsushita K,et al.Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality[J].JAMA,2014,311(24):2518-2531.DOI:10.1001/jama.2014.6634.
[73] Morton JI,Liew D,McDonald SP,et al.The association between age of onset of type 2 diabetes and the long-term risk of end-stage kidney disease:a national registry study[J].Diabetes Care,2020,43(8):1788-1795.DOI:10.2337/dc20-0352.
[74] Skupien J,Smiles AM,Valo E,et al.Variations in risk of end-stage renal disease and risk of mortality in an international study of patients with type 1 diabetes and advanced nephropathy[J].Diabetes Care,2019,42(1):93-101.DOI:10.2337/dc18-1369.
[75] GBD 2017 Causes of Death Collaborators.Global,regional,and national age-sex-specific mortality for 282 causes of death in 195 countries and territories,1980-2017:a systematic analysis for the Global Burden of Disease Study 2017[J].Lancet,2018,392(10159):1736-1788.DOI:10.1016/S0140-6736(18)32203-7.
[76] Fragoso A,Mendes F,Silva AP,et al.Insulin resistance as a predictor of cardiovascular morbidity and end-stage renal disease[J].J Diabetes Complications,2015,29(8):1098-1104.DOI:10.1016/j.jdiacomp.2015.05.010.
[77] Yamanouchi M,Furuichi K,Hoshino J,et al.Nonproteinuric versus proteinuric phenotypes in diabetic kidney disease:a propensity score-matched analysis of a nationwide,biopsy-based Cohort study[J].Diabetes Care,2019,42(5):891-902.DOI:10.2337/dc18-1320.
[78] Rhee CM,Kovesdy CP,You AS,et al.Hypoglycemia-related hospitalizations and mortality among patients with diabetes transitioning to dialysis[J].Am J Kidney Dis,2018,72(5):701-710.DOI:10.1053/j.ajkd.2018.04.022.
[79] 杨超,王晋伟,杨尧政,等.贫血及慢性肾脏病对糖尿病人群心脑血管事件发生与死亡的影响[J].北京大学学报(医学版),2018,50(3):495-500.DOI:10.3969/j.issn.1671-167X.2018.03.017.
[80] Soh CH,Ul Hassan SW,Sacre J,et al.Morbidity measures predicting mortality in inpatients:a systematic review[J].J Am Med Dir Assoc,2020,21(4):462-468.e7.DOI:10.1016/j.jamda.2019.12.001.
[81] Huang YQ,Gou R,Diao YS,et al.Charlson comorbidity index helps predict the risk of mortality for patients with type 2 diabetic nephropathy[J].J Zhejiang Univ Sci B,2014,15(1):58-66.DOI:10.1631/jzus.B1300109.
[82] Perkins BA,Bebu I,de Boer IH,et al.Risk factors for kidney disease in type 1 diabetes[J].Diabetes Care,2019,42(5):883-890.DOI:10.2337/dc18-2062.
[83] Jiang W,Wang J,Shen X,et al.Establishment and validation of a risk prediction model for early diabetic kidney disease based on a systematic review and Meta-analysis of 20 Cohorts[J].Diabetes Care,2020,43(4):925-933.DOI:10.2337/dc19-1897.
[84] Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes(UKPDS 33).UK Prospective Diabetes Study(UKPDS)Group[J].Lancet,1998,352(9131):837-853.
[85] de Boer IH,DCCT/EDIC Research Group.Kidney disease and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study[J].Diabetes Care,2014,37(1):24-30.DOI:10.2337/dc13-2113.
[86] de Boer IH,Sun W,Cleary PA,et al.Intensive diabetes therapy and glomerular filtration rate in type 1 diabetes[J].N Engl J Med,2011,365(25):2366-2376.DOI:10.1056/NEJMoa1111732.
[87] Ismail-Beigi F,Craven T,Banerji MA,et al.Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes:an analysis of the ACCORD randomised trial[J].Lancet,2010,376(9739):419-430.DOI:10.1016/S0140-6736(10)60576-4.
[88] Ikizler TA,Robinson-Cohen C,Ellis C,et al.Metabolic effects of diet and exercise in patients with moderate to severe CKD:a randomized clinical trial[J].J Am Soc Nephrol,2018,29(1):250-259.DOI:10.1681/ASN.2017010020.
[89] Dunkler D,Dehghan M,Teo KK,et al.Diet and kidney disease in high-risk individuals with type 2 diabetes mellitus[J].JAMA Intern Med,2013,173(18):1682-1692.DOI:10.1001/jamainternmed.2013.9051.
[90] Ikizler TA,Burrowes JD,Byham-Gray LD,et al.KDOQI clinical practice guideline for nutrition in CKD:2020 update[J].Am J Kidney Dis,2020,76(3 Suppl 1):S1-S107.DOI:10.1053/j.ajkd.2020.05.006.
[91] Hahn D,Hodson EM,Fouque D.Low protein diets for non-diabetic adults with chronic kidney disease[J].Cochrane Database Syst Rev,2020,10(10):CD001892.DOI:10.1002/14651858.CD001892.pub5.
[92] Kelly JT,Palmer SC,Wai SN,et al.Healthy dietary patterns and risk of mortality and ESRD in CKD:a Meta-analysis of Cohort studies[J].Clin J Am Soc Nephrol,2017,12(2):272-279.DOI:10.2215/CJN.06190616.
[93] Thomas MC,Moran J,Forsblom C,et al.The association between dietary sodium intake,ESRD,and all-cause mortality in patients with type 1 diabetes[J].Diabetes Care,2011,34(4):861-866.DOI:10.2337/dc10-1722.
[94] D'Elia L,Rossi G,Schiano DC,et al.Meta-analysis of the effect of dietary sodium restriction with or without concomitant renin-angiotensin-aldosterone system-inhibiting treatment on albuminuria[J].Clin J Am Soc Nephrol,2015,10(9):1542-1552.DOI:10.2215/CJN.09110914.
[95] Lambers Heerspink HJ,Holtkamp FA,Parving HH,et al.Moderation of dietary sodium potentiates the renal and cardiovascular protective effects of angiotensin receptor blockers[J].Kidney Int,2012,82(3):330-337.DOI:10.1038/ki.2012.74.
[96] Ekinci EI,Clarke S,Thomas MC,et al.Dietary salt intake and mortality in patients with type 2 diabetes[J].Diabetes Care,2011,34(3):703-709.DOI:10.2337/dc10-1723.
[97] Jiang N,Huang F,Zhang X.Smoking and the risk of diabetic nephropathy in patients with type 1 and type 2 diabetes:a meta-analysis of observational studies[J].Oncotarget,2017,8(54):93209-93218.DOI:10.18632/oncotarget.21478.
[98] Staplin N,Haynes R,Herrington WG,et al.Smoking and adverse outcomes in patients With CKD:The Study of Heart and Renal Protection(SHARP)[J].Am J Kidney Dis,2016,68(3):371-380.DOI:10.1053/j.ajkd.2016.02.052.
[99] Ohkuma T,Nakamura U,Iwase M,et al.Effects of smoking and its cessation on creatinine-and cystatin C-based estimated glomerular filtration rates and albuminuria in male patients with type 2 diabetes mellitus:the Fukuoka Diabetes Registry[J].Hypertens Res,2016,39(10):744-751.DOI:10.1038/hr.2016.51.
[100] Dempsey PC,Larsen RN,Sethi P,et al.Benefits for type 2 diabetes of interrupting prolonged sitting with brief bouts of light walking or simple resistance activities[J].Diabetes Care,2016,39(6):964-972.DOI:10.2337/dc15-2336.
[101] Colberg SR,Sigal RJ,Yardley JE,et al.Physical activity/exercise and diabetes:a position statement of the American Diabetes Association[J].Diabetes Care,2016,39(11):2065-2079.DOI:10.2337/dc16-1728.
[102] Greenwood SA,Castle E,Lindup H,et al.Mortality and morbidity following exercise-based renal rehabilitation in patients with chronic kidney disease:the effect of programme completion and change in exercise capacity[J].Nephrol Dial Transplant,2019,34(4):618-625.DOI:10.1093/ndt/gfy351.
[103] Look AHEAD Research Group.Effect of a long-term behavioural weight loss intervention on nephropathy in overweight or obese adults with type 2 diabetes:a secondary analysis of the Look AHEAD randomised clinical trial[J].Lancet Diabetes Endocrinol,2014,2(10):801-809.DOI:10.1016/S2213-8587(14)70156-1.
[104] Bjornstad P,Hughan K,Kelsey MM,et al.Effect of surgical versus medical therapy on diabetic kidney disease over 5 years in severely obese adolescents with type 2 diabetes[J].Diabetes Care,2020,43(1):187-195.DOI:10.2337/dc19-0708.
[105] Liakopoulos V,Franzén S,Svensson AM,et al.Renal and cardiovascular outcomes after weight loss from gastric bypass surgery in type 2 diabetes:cardiorenal risk reductions exceed atherosclerotic benefits[J].Diabetes Care,2020,43(6):1276-1284.DOI:10.2337/dc19-1703.
[106] Singh P,Adderley N,Subramanian A,et al.The impact of bariatric surgery on incident microvascular complications in patients with type 2 diabetes:a matched controlled population-based retrospective Cohort study[J].Diabetes Care,2021,44(1):116-124.DOI:10.2337/dc20-0571.
[107] Galindo RJ,Beck RW,Scioscia MF,et al.Glycemic monitoring and management in advanced chronic kidney disease[J].Endocr Rev,2020,41(5):756-774.DOI:10.1210/endrev/bnaa017.
[108] Zelnick LR,Batacchi ZO,Ahmad I,et al.Continuous glucose monitoring and use of alternative markers to assess glycemia in chronic kidney disease[J].Diabetes Care,2020,43(10):2379-2387.DOI:10.2337/dc20-0915.
[109] Battelino T,Danne T,Bergenstal RM,et al.Clinical targets for continuous glucose monitoring data interpretation:recommendations from the international consensus on time in range[J].Diabetes Care,2019,42(8):1593-1603.DOI:10.2337/dci19-0028.
[110] DCCT/EDIC research group.Effect of intensive diabetes treatment on albuminuria in type 1 diabetes:long-term follow-up of the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications study[J].Lancet Diabetes Endocrinol,2014,2(10):793-800.DOI:10.1016/S2213-8587(14)70155-X.
[111] Patel A,MacMahon S,Chalmers J,et al.Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes[J].N Engl J Med,2008,358(24):2560-2572.DOI:10.1056/NEJMoa0802987.
[112] Zoungas S,Chalmers J,Neal B,et al.Follow-up of blood-pressure lowering and glucose control in type 2 diabetes[J].N Engl J Med,2014,371(15):1392-1406.DOI:10.1056/NEJMoa1407963.
[113] Agrawal L,Azad N,Bahn GD,et al.Long-term follow-up of intensive glycaemic control on renal outcomes in the Veterans Affairs Diabetes Trial(VADT)[J].Diabetologia,2018,61(2):295-299.DOI:10.1007/s00125-017-4473-2.
[114] Papademetriou V,Lovato L,Doumas M,et al.Chronic kidney disease and intensive glycemic control increase cardiovascular risk in patients with type 2 diabetes[J].Kidney Int,2015,87(3):649-659.DOI:10.1038/ki.2014.296.
[115] Gerstein HC,Miller ME,Byington RP,et al.Effects of intensive glucose lowering in type 2 diabetes[J].N Engl J Med,2008,358(24):2545-2559.DOI:10.1056/NEJMoa0802743.
[116] Huang ES,Liu JY,Moffet HH,et al.Glycemic control,complications,and death in older diabetic patients:the diabetes and aging study[J].Diabetes Care,2011,34(6):1329-1336.DOI:10.2337/dc10-2377.
[117] Currie CJ,Peters JR,Tynan A,et al.Survival as a function of HbA(1c)in people with type 2 diabetes:a retrospective cohort study[J].Lancet,2010,375(9713):481-489.DOI:10.1016/S0140-6736(09)61969-3.
[118] Perkovic V,Heerspink HL,Chalmers J,et al.Intensive glucose control improves kidney outcomes in patients with type 2 diabetes[J].Kidney Int,2013,83(3):517-523.DOI:10.1038/ki.2012.401.
[119] Wong MG,Perkovic V,Chalmers J,et al.Long-term benefits of intensive glucose control for preventing end-stage kidney disease:ADVANCE-ON[J].Diabetes Care,2016,39(5):694-700.DOI:10.2337/dc15-2322.
[120] Beck RW,Bergenstal RM,Riddlesworth TD,et al.Validation of time in range as an outcome measure for diabetes clinical trials[J].Diabetes Care,2019,42(3):400-405.DOI:10.2337/dc18-1444.
[121] Wanner C,Inzucchi SE,Lachin JM,et al.Empagliflozin and progression of kidney disease in type 2 diabetes[J].N Engl J Med,2016,375(4):323-334.DOI:10.1056/NEJMoa1515920.
[122] Cherney D,Zinman B,Inzucchi SE,et al.Effects of empagliflozin on the urinary albumin-to-creatinine ratio in patients with type 2 diabetes and established cardiovascular disease:an exploratory analysis from the EMPA-REG OUTCOME randomised,placebo-controlled trial[J].Lancet Diabetes Endocrinol,2017,5(8):610-621.DOI:10.1016/S2213-8587(17)30182-1.
[123] Neal B,Perkovic V,Mahaffey KW,et al.Canagliflozin and cardiovascular and renal events in type 2 diabetes[J].N Engl J Med,2017,377(7):644-657.DOI:10.1056/NEJMoa1611925.
[124] Perkovic V,Jardine MJ,Neal B,et al.Canagliflozin and renal outcomes in type 2 diabetes and nephropathy[J].N Engl J Med,2019,380(24):2295-2306.DOI:10.1056/NEJMoa1811744.
[125] Akinci B.Dapagliflozin and cardiovascular outcomes in type 2 diabetes[J].N Engl J Med,2019,380(19):1881.DOI:10.1056/NEJMc1902837.
[126] Heerspink H,Stefánsson BV,Correa-Rotter R,et al.Dapagliflozin in patients with chronic kidney disease[J].N Engl J Med,2020,383(15):1436-1446.DOI:10.1056/NEJMoa2024816.
[127] Mann J,ørsted DD,Brown-Frandsen K,et al.Liraglutide and renal outcomes in type 2 diabetes[J].N Engl J Med,2017,377(9):839-848.DOI:10.1056/NEJMoa1616011.
[128] Marso SP,Bain SC,Consoli A,et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes[J].N Engl J Med,2016,375(19):1834-1844.DOI:10.1056/NEJMoa1607141.
[129] Tuttle KR,Lakshmanan MC,Rayner B,et al.Dulaglutide versus insulin glargine in patients with type 2 diabetes and moderate-to-severe chronic kidney disease(AWARD-7):a multicentre,open-label,randomised trial[J].Lancet Diabetes Endocrinol,2018,6(8):605-617.DOI:10.1016/S2213-8587(18)30104-9.
[130] Gerstein HC,Colhoun HM,Dagenais GR,et al.Dulaglutide and renal outcomes in type 2 diabetes:an exploratory analysis of the REWIND randomised,placebo-controlled trial[J].Lancet,2019,394(10193):131-138.DOI:10.1016/S0140-6736(19)31150-X.
[131] Buse JB,Wexler DJ,Tsapas A,et al.2019 update to:management of hyperglycaemia in type 2 diabetes,2018.A consensus report by the American Diabetes Association(ADA)and the European Association for the Study of Diabetes(EASD)[J].Diabetologia,2020,63(2):221-228.DOI:10.1007/s00125-019-05039-w.
[132] Neuen BL,Young T,Heerspink H,et al.SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes:a systematic review and meta-analysis[J].Lancet Diabetes Endocrinol,2019,7(11):845-854.DOI:10.1016/S2213-8587(19)30256-6.
[133] Heerspink H,Karasik A,Thuresson M,et al.Kidney outcomes associated with use of SGLT2 inhibitors in real-world clinical practice(CVD-REAL 3):a multinational observational cohort study[J].Lancet Diabetes Endocrinol,2020,8(1):27-35.DOI:10.1016/S2213-8587(19)30384-5.
[134] Hamblin PS,Wong R,Ekinci EI,et al.SGLT2 inhibitors increase the risk of diabetic ketoacidosis developing in the community and during hospital admission[J].J Clin Endocrinol Metab,2019,104(8):3077-3087.DOI:10.1210/jc.2019-00139.
[135] Wang X,Zhang H,Zhang Q,et al.Exenatide and renal outcomes in patients with type 2 diabetes and diabetic kidney disease[J].Am J Nephrol,2020,51(10):806-814.DOI:10.1159/000510255.
[136] Kristensen SL,Rørth R,Jhund PS,et al.Cardiovascular,mortality,and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes:a systematic review and meta-analysis of cardiovascular outcome trials[J].Lancet Diabetes Endocrinol,2019,7(10):776-785.DOI:10.1016/S2213-8587(19)30249-9.
[137] Palmer SC,Tendal B,Mustafa RA,et al.Sodium-glucose cotransporter protein-2(SGLT-2)inhibitors and glucagon-like peptide-1(GLP-1)receptor agonists for type 2 diabetes:systematic review and network meta-analysis of randomised controlled trials[J].BMJ,2021,372:m4573.DOI:10.1136/bmj.m4573.
[138] Holman RR,Paul SK,Bethel MA,et al.10-year follow-up of intensive glucose control in type 2 diabetes[J].N Engl J Med,2008,359(15):1577-1589.DOI:10.1056/NEJMoa0806470.
[139] Crowley MJ,Diamantidis CJ,McDuffie JR,et al.Clinical outcomes of metformin use in populations with chronic kidney disease,congestive heart failure,or chronic liver disease:a systematic review[J].Ann Intern Med,2017,166(3):191-200.DOI:10.7326/M16-1901.
[140] Charytan DM,Solomon SD,Ivanovich P,et al.Metformin use and cardiovascular events in patients with type 2 diabetes and chronic kidney disease[J].Diabetes Obes Metab,2019,21(5):1199-1208.DOI:10.1111/dom.13642.
[141] Lalau JD,Kajbaf F,Bennis Y,et al.Metformin treatment in patients with type 2 diabetes and chronic kidney disease stages 3A,3B,or 4[J].Diabetes Care,2018,41(3):547-553.DOI:10.2337/dc17-2231.
[142] van der Molen AJ,Reimer P,Dekkers IA,et al.Post-contrast acute kidney injury.Part 2:risk stratification,role of hydration and other prophylactic measures,patients taking metformin and chronic dialysis patients:recommendations for updated ESUR Contrast Medium Safety Committee guidelines[J].Eur Radiol,2018,28(7):2856-2869.DOI:10.1007/s00330-017-5247-4.
[143] Rosenstock J,Perkovic V,Johansen OE,et al.Effect of linagliptin vs placebo on major cardiovascular events in adults with type 2 diabetes and high cardiovascular and renal risk:the CARMELINA randomized clinical trial[J].JAMA,2019,321(1):69-79.DOI:10.1001/jama.2018.18269.
[144] Cornel JH,Bakris GL,Stevens SR,et al.Effect of sitagliptin on kidney function and respective cardiovascular outcomes in type 2 diabetes:outcomes from TECOS[J].Diabetes Care,2016,39(12):2304-2310.DOI:10.2337/dc16-1415.
[145] Mosenzon O,Leibowitz G,Bhatt DL,et al.Effect of saxagliptin on renal outcomes in the SAVOR-TIMI 53 Trial[J].Diabetes Care,2017,40(1):69-76.DOI:10.2337/dc16-0621.
[146] Inoue T,Shibahara N,Miyagawa K,et al.Pharmacokinetics of nateglinide and its metabolites in subjects with type 2 diabetes mellitus and renal failure[J].Clin Nephrol,2003,60(2):90-95.DOI:10.5414/cnp60090.
[147] Zhou Y,Huang Y,Ji X,et al.Pioglitazone for the primary and secondary prevention of cardiovascular and renal outcomes in patients with or at high risk of type 2 diabetes mellitus:a Meta-analysis[J].J Clin Endocrinol Metab,2020,105(5):dgz252.DOI:10.1210/clinem/dgz252.
[148] Rave K,Heise T,Pfützner A,et al.Impact of diabetic nephropathy on pharmacodynamic and Pharmacok

相似文献/References:

[1]包薇萍,刘超.巨分子促甲状腺激素的筛查策略[J].国际内分泌代谢杂志,2017,37(01):21.[doi:10.3760/cma.j.issn.1673-4157.2017.01.06]
 Bao Weiping,Liu Chao..Screening strategy for macro-thyroid-stimulating hormone[J].International Journal of Endocrinology and Metabolism,2017,37(04):21.[doi:10.3760/cma.j.issn.1673-4157.2017.01.06]
[2]高忠爱,杨波,郑妙艳,等.糖尿病合并大量蛋白尿的中西医治疗策略[J].国际内分泌代谢杂志,2021,41(06):583.[doi:10.3760/cma.j.cn121383-20210930-09088]
 Gao Zhongai,Yang Bo,Zheng Miaoyan,et al.Treatment strategies of traditional Chinese and western medicine in diabetic patients with overt proteinuria[J].International Journal of Endocrinology and Metabolism,2021,41(04):583.[doi:10.3760/cma.j.cn121383-20210930-09088]
[3]吴静,冉兴无.糖尿病下肢动脉病变的早期筛查与规范化管理[J].国际内分泌代谢杂志,2021,41(06):587.[doi:10.3760/cma.j.cn121383-20210922-09064]
 Wu Jing,Ran Xingwu..Early screening and standardized management of artery disease in diabetic lower extremity[J].International Journal of Endocrinology and Metabolism,2021,41(04):587.[doi:10.3760/cma.j.cn121383-20210922-09064]
[4]谷巍,宋光耀,李晓龙.肾脏异位脂质沉积与糖尿病肾脏病脂毒性机制的研究进展[J].国际内分泌代谢杂志,2022,42(03):199.[doi:10.3760/cma.j.cn121383-20210324-03067]
 Gu Wei,Song Guangyao,Li Xiaolong..Research progress of renal ectopic lipid deposition and the mechanism of lipid toxicity in diabetic kidney disease[J].International Journal of Endocrinology and Metabolism,2022,42(04):199.[doi:10.3760/cma.j.cn121383-20210324-03067]
[5]许媛 许岚 张丽华 李启富 杨淑敏.中国原发性醛固酮增多症诊断现状调查研究[J].国际内分泌代谢杂志,2022,42(04):288.[doi:10.3760/cma.j.cn121383-20201221-12058]
 Xu Yuan,Xu Lan,Zhang Lihua,et al.Investigation on current status of diagnosis of primary aldosteronism in China[J].International Journal of Endocrinology and Metabolism,2022,42(04):288.[doi:10.3760/cma.j.cn121383-20201221-12058]
[6]黄婧荷,宋焱,郭立新.糖尿病肾脏病的磁共振成像评估方法及进展[J].国际内分泌代谢杂志,2023,43(04):309.[doi:10.3760/cma.j.cn121383-20220403-04007]
 Huang Jinghe,Song Yan,Guo Lixin.Magnetic resonance imaging in diabetic kidney disease:assessment and update[J].International Journal of Endocrinology and Metabolism,2023,43(04):309.[doi:10.3760/cma.j.cn121383-20220403-04007]
[7]范巧明,罗冬强,蔡惠连,等.基于生信分析及实验验证探讨中医药抗糖尿病肾脏病的组方规律及作用机制[J].国际内分泌代谢杂志,2024,44(03):155.[doi:10.3760/cma.j.cn121383-20231022-10037]
 Fan Qiaoming,Luo Dongqiang,Cai Huilian,et al.Based on bioinformatics analysis and experimental verification, the composition and mechanism of TCM anti-diabetic nephropathy were discussed[J].International Journal of Endocrinology and Metabolism,2024,44(04):155.[doi:10.3760/cma.j.cn121383-20231022-10037]
[8]赵妍,郭佳欣,程健,等.肾脏免疫球蛋白沉积与糖尿病肾脏病的临床相关性研究[J].国际内分泌代谢杂志,2024,44(03):161.[doi:10.3760/cma.j.cn121383-20240124-01067]
 Zhao Yan,Guo Jiaxin,Cheng Jian,et al.Study on the clinical associations between different types of renal immunoglobulin deposition and diabetic kidney disease[J].International Journal of Endocrinology and Metabolism,2024,44(04):161.[doi:10.3760/cma.j.cn121383-20240124-01067]

备注/Memo

备注/Memo:
通信作者:薛耀明,南方医科大学南方医院内分泌代谢科,广州 510515,Email:yaomingxue@126.com; 朱大龙,南京大学医学院附属鼓楼医院内分泌科 210008,Email:zhudalong@nju.edu.cn
更新日期/Last Update: 1900-01-01