Diabetic Kidney Disease

Clinical journal of the American Society of Nephrology : CJASN - Tập 12 Số 12 - Trang 2032-2045 - 2017
Radica Z. Alicic1,2, Michele T. Rooney1, Katherine R. Tuttle3,4,5,1,2
1Providence Health Care, Spokane, Washington
2University of Washington School of Medicine, Seattle, Washington
3Division of Nephrology, University of Washington School of Medicine, Seattle, Washington
4Institute of Translational Health Sciences, Seattle, Washington; and
5Kidney Research Institute, Seattle, Washington

Tóm tắt

Diabetic kidney disease develops in approximately 40% of patients who are diabetic and is the leading cause of CKD worldwide. Although ESRD may be the most recognizable consequence of diabetic kidney disease, the majority of patients actually die from cardiovascular diseases and infections before needing kidney replacement therapy. The natural history of diabetic kidney disease includes glomerular hyperfiltration, progressive albuminuria, declining GFR, and ultimately, ESRD. Metabolic changes associated with diabetes lead to glomerular hypertrophy, glomerulosclerosis, and tubulointerstitial inflammation and fibrosis. Despite current therapies, there is large residual risk of diabetic kidney disease onset and progression. Therefore, widespread innovation is urgently needed to improve health outcomes for patients with diabetic kidney disease. Achieving this goal will require characterization of new biomarkers, designing clinical trials that evaluate clinically pertinent end points, and development of therapeutic agents targeting kidney-specific disease mechanisms (e.g., glomerular hyperfiltration, inflammation, and fibrosis). Additionally, greater attention to dissemination and implementation of best practices is needed in both clinical and community settings.Introduction

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