[1]丁静雅,梁雅灵,徐勇,等.糖尿病正常白蛋白尿而肾功能不全的研究进展[J].国际内分泌代谢杂志,2016,36(05):349-351.[doi:10.3760/cma.j.issn.1673-4157.2016.05.17]
 Ding Jingya,Liang Yaling,Xu Yong,et al.Update of normoalbuminuric renal insufficiency in diabetes[J].International Journal of Endocrinology and Metabolism,2016,36(05):349-351.[doi:10.3760/cma.j.issn.1673-4157.2016.05.17]
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糖尿病正常白蛋白尿而肾功能不全的研究进展()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
36
期数:
2016年05期
页码:
349-351
栏目:
综述
出版日期:
2016-09-20

文章信息/Info

Title:
Update of normoalbuminuric renal insufficiency in diabetes
作者:
丁静雅梁雅灵徐勇李衍辉
646000 沪州,西南医科大学附属医院内分泌科
Author(s):
Ding Jingya Liang Yaling Xu Yong Li Yanhui
Department of Endocrinology, The Affiliated Hospital of Southwest Medical University,Luzhou 646000, China
关键词:
糖尿病肾病 正常白蛋白尿 肾功能不全
Keywords:
Diabetic nephropathy Normoalbuminuria Renal insufficiency
DOI:
10.3760/cma.j.issn.1673-4157.2016.05.17
摘要:
糖尿病肾病是导致终末期肾病的一个主要原因,而微量白蛋白尿是糖尿病肾病的一个重要临床表现 。近期研究表明,正常白蛋白尿而肾功能不全的情况在糖尿病患者中并不少见,尤其是2型糖尿病。正常白蛋白 尿而肾功能不全的发病机制可能与肾间质纤维化、缺血性血管疾病以及尿液中尿白蛋白碎片的比例增加有关。 其临床特点为女性比例较高,糖尿病病程较短,高血压发病率更低等。正常白蛋白尿而肾功能不全的病理特点为 整体肾小球硬化。目前关于正常白蛋白尿而肾功能不全的治疗与白蛋白尿肾功能不全的患者并没有什么不同, 而其预后可能比后者更好。
Abstract:
Diabetic nephropathy is a leading cause of end-stage renal disease and microalbuminuria has been considered as the first clinical sign of diabetic nephropathy. However, recent studies demonstrated that normoalbuminuric renal insufficiency is not uncommon for diabetic patients, especially in type 2 diabetes mellitus. The pathogenesis of normoalbuminuric renal insufficiency is related to renal interstitial fibrosis and ischemic vascular disease and increase of proportion of protein fragments in urine. Its clinical characteristics is associated with a higher proportion of female, a shorter duration of diabetes, lower prevalence of hypertension. The pathological characteristics associated with normoalbuminuric renal insufficiency in diabetes is global glomerular sclerosis. The treatment of normoalbuminuric renal insufficiency is similar to the treatment of albuminuric renal insufficiency and studies have shown that normal albuminuria renal insufficiency patients may have a better outcome compared to the latter.

参考文献/References:

[1] Japan nephrology society. Clinical practice guidebook for diagnosis and treatment of chronic kidney disease 2012[J].Nihon Jinzo Gakkai Shi,2012,54(8):1034-1191.
[2] Wada T, Shimizu M, Toyama T, et al. Clinical impact of albuminuria in diabetic nephropathy [J].Clin Exp Nephrol,2012,16(1):96-101. DOI: 10.1007/s10157-011-0508-z.
[3] Levey AS, de Jong PE, Coresh J,et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO controversies conference report[J].Kidney Int,2011,80(1):17-28. DOI: 10.1038/ki.2010.483.
[4] 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.
[5] 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.
[6] 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.
[7] Taniwaki H, Nishizawa Y, Kawagishi T,et al. Decrease in glomerular filtration rate in Japanese patients with type 2 diabetes is linked to atherosclerosis[J].Diabetes Care,1998,21 (11):1848-1855.
[8] MacIsaac RJ, Panagiotopoulos S, McNeil KJ,et al. Is nonalbuminuric renal insufficiency in type 2 diabetes related to an increase in intrarenal vascular disease?[J].Diabetes Care,2006,29 (7):1560-1566.
[9] Macisaac RJ, Jerums G. Diabetic kidney disease with and without albuminuria[J].Curr Opin Nephrol Hypertens,2011,20(3):246-257. DOI: 10.1097/MNH.0b013e3283456546.
[10] Rigalleau V, Lasseur C, Raffaitin C, et al. Normoalbuminuric renal-insufficient diabetic patients: a lower-risk group[J].Diabetes Care,2007,30(8):2034-2039.
[11] Lane PH, Steffes MW, Mauer SM. Glomerular structure in IDDM women with low glomerular filtration rate and normal urinary albumin excretion[J].Diabetes,1992,41(5):581-586.
[12] Yagil C, Barak A, Ben-Dor D, et al. Nonproteinuric diabetes-associated nephropathy in the Cohen rat model of type 2 diabetes[J].Diabetes,2005,54(5):1487-1496.
[13] Shimizu M, Furuichi K, Toyama T, et al. Long-term outcomes of Japanese type 2 diabetic patients with biopsy-proven diabetic nephropathy[J].Diabetes Care,2013,36(11):3655-3662. DOI: 10.2337/dc13-0298.
[14] Mora-Fernández C, Domínguez-Pimentel V, de Fuentes MM, et al. Diabetic kidney disease: from physiology to therapeutics[J].J Physiol,2014,592(18):3997-4012. DOI: 10.1113/jphysiol.2014.272328.
[15] Bruno G, Merletti F, Bargero G,et al. Estimated glomerular filtration rate, albuminuria and mortality in type 2 diabetes: the Casale Monferrato study[J].Diabetologia,2007,50(5):941-948.
[16] Babazono T, Nyumura I, Toya K,et al. Higher levels of urinary albumin excretion within the normal range predict faster decline in glomerular filtration rate in diabetic patients [J].Diabetes Care,2009,32(8):1518-1520. DOI: 10.2337/dc08-2151.
[17] Ruggenenti P, Porrini E, Motterlini N,et al. Measurable urinary albumin predicts cardiovascular risk among normoalbuminuric patients with type 2 diabetes[J].J Am Soc Nephrol,2012,23(10):1717-1724.DOI:10.1681/ASN.2012030252.
[18] Ninomiya T, Perkovic V, de Galan BE,et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes[J].J Am Soc Nephrol,2009,20(8):1813-1821. DOI: 10.1681/ASN.2008121270.
[19] Yokoyama H, Oishi M, Kawai K, et al. Reduced GFR and microalbuminuria are independently associated with prevalent cardiovascular disease in type 2 diabetes: JDDM study 16[J].Diabet Med,2008,25(12):1426-1432.DOI: 10.1111/j.1464-5491.2008.02592.x.
[20] Toyama T, Furuichi K, Ninomiya T, et al. The impacts of albuminuria and low eGFR on the risk of cardiovascular death, all-cause mortality, and renalevents in diabetic patients: meta- analysis[J].PLoS One,2013,8(8):e71810. DOI: 10.1371/journal.pone.0071810.

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备注/Memo

备注/Memo:
基金项目:四川省教育厅重点项目(10ZA036); 四川省国际合作项目(14GH0003) 通信作者:徐勇, Email:xywyll@aliyun.com
更新日期/Last Update: 2016-11-20