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DIABETES MELLITUS AND CHRONIC KIDENY DISEASE: MODERN DIAGNOSTICS AND TREATMENT
- Authors: Shestakova М.V.1
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Affiliations:
- Scientific centre of endocrinology Ministry of Healthcare and Social development of Russia, Moscow
- Issue: Vol 67, No 1 (2012)
- Pages: 45-49
- Section: SHORT MESSAGES
- Published: 22.01.2012
- URL: https://vestnikramn.spr-journal.ru/jour/article/view/355
- DOI: https://doi.org/10.15690/vramn.v67i1.109
- ID: 355
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Abstract
Diabetic nephropathy (DN) – is a leading cause of terminal renal failure in the developed countries. Kidney pathology development undergoes several
stages – from preclinical structural changes in the first years of the disease to diffuse or nodular glomerulosclerosis 15-20 years after the diabetes onset. Microalbuminuria is an early marker of DN. Intensive treatment of DN at the stage of microalbuminuria leads to regress and remission of lab parameters of DN in 40 – 50 % of patients after 2 years of treatment. Prognostic factors of DN remission are: tight glycaemia control, arterial hypertension control, especially while treated with renin-angiotensin blockers. Regress of structural changes of kidney tissue In a diabetic patient is possible only after a long-term (>10yrs) normoglycaemia maintenance.
stages – from preclinical structural changes in the first years of the disease to diffuse or nodular glomerulosclerosis 15-20 years after the diabetes onset. Microalbuminuria is an early marker of DN. Intensive treatment of DN at the stage of microalbuminuria leads to regress and remission of lab parameters of DN in 40 – 50 % of patients after 2 years of treatment. Prognostic factors of DN remission are: tight glycaemia control, arterial hypertension control, especially while treated with renin-angiotensin blockers. Regress of structural changes of kidney tissue In a diabetic patient is possible only after a long-term (>10yrs) normoglycaemia maintenance.
About the authors
М. V. Shestakova
Scientific centre of endocrinology Ministry of Healthcare and Social development of Russia, Moscow
Author for correspondence.
Email: nephro@endocrincentr.ru
доктор медицинских наук, профессор, член-корр. РАМН, директор Института диабета ФГБУ «Эндокринологический научный центр» Минздравсоцразвития России Адрес: 117036, Москва, ул. Дм. Ульянова, 11 Тел./факс: (499) 124-45-00 Россия
References
- Excerpts from the United States Renal Data System 2007 annual data report. Am. J. Kidney Dis. 2008; 51 (1 Suppl. 1): 1–320.
- Bikbov B.T., Tomilina N.A. Nefrologiya i dializ = Nephrology and dialysis. 2009; 3: 146–221.
- Maslova O.V, Suncov Yu.I., Shestakova M.V. et al. Klinicheskaya nefrologiya = Clinical nephrology. 2010; 3: 45–51.
- Shamhalova M.Sh., Trubicyna N.P., Zaiceva N.V., Shestakova M.V. Trudnyi pacient = Difficult patient. 2006; 8: 73–76.
- Shestakova M.V., Neverov I.I., Dedov I.I. Ter. arhiv = Therapeutic archive. 1993; 6: 61–65.
- Shestakova M.V., Dedov I.I. Saharnyi diabet i hronicheskaya bolezn' pochek [Diabetes and Chronic Kidney Disease]. Moscow, Medicinskoe informacionnoe agentstvo, 2009. 482 p.
- Otu H.H., Can H., Spentzos D. et. al. Prediction of diabetic nephropathy using urine proteomic profiling 10 years prior to development of nephropathy. Diabetes Care. 2007; 30 (3): 638–643.
- Tervaert T.W., Mooyaart A.L., Amann K. et al. Оn behalf of the Renal Pathology Society. Pathologic Classification of Diabetic NEPHROPATHY. J. Am. Soc. Nephrol. 2010; 21 (4): 556–563.
- Giorgino F., Laviola L., Cavallo Perin P. et al. Factors associated with progression to macroalbuminuria in microalbuminuric type 1 diabetic patients: the EURODIAB Prospective Complications Study. Diabetologia. 2004; 47: 1020–1028.
- G de P., Tarnow L., Vedel P. et al. Remission to normoalbuminuria during multifactorial treatment preserves kidney function in patients with type 2 diabetes and microalbuminuria. Nephrol. Dial. Transplant. 2004; 19: 2784 –2788.
- Araki S., Haneda M., Sugimoto T. et al. Factors Associated With Frequent Remission of Microalbuminuria in Patients With Type 2 Diabetes. Diabetes. 2005; 54: 2983–2987.
- de Zeeuw D., Remuzzi G., Parving H.-H. et al. Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL. Kidney Int. 2004; 65: 2309–2320.
- The ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N. Engl. J. Med. 2008; 358: 2560–2572.
- Fioretto P., Steffes M.W., Sutherland D.E. et al. Reversal of lesions of diabetic nephropathy after pancreas transplantation. N. Engl. J. Med. 1998; 339 (2): 69–75.
- Shikata K., Haneda M., Koya D. et al. Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT-Japan): Rationale and study design. Diabetes Research and Clinical Practice. 2010; 87: 228–232.
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