摘要
糖尿病(DM)因其发病率高,已成为重要的全球公共卫生问题。糖尿病肾脏疾病(DKD)是导致终末期肾脏病(ESKD)的主要原因,因此,DKD的早期诊断和及时防治对延缓DM进展非常重要。DKD的临床诊断与分期多依据尿白蛋白排泄率(UAER)和估算的肾小球滤过率(eGFR),但临床上许多DKD患者的肾脏受累并不表现为临床蛋白尿,而表现出正常白蛋白尿糖尿病肾脏疾病(NADKD)。随着美国肾脏基金会和食品与药品管理局(NKF/FDA)对正常白蛋白尿的重新定义,旧的NADKD概念不再适合,应随之更新。本文基于DM和慢性肾脏疾病(CKD)相关指南,结合临床研究现状,从流行病学、病理机制、疾病诊断、临床特征与生物标志物等方面对NADKD进行了描述,以期引起同行新的认识并予以重视。
Diabetes mellitus(DM)has grown up to be an important issue of global public health because of its high incidence rate.Diabetic kidney disease(DKD)is the main cause of end-stage kidney disease(ESKD).Therefore,early diagnosis and timely prevention and treatment of DKD are essential for the progress of DM.The clinical diagnosis and staging of DKD are mostly based on the urinary albumin excretion rate(UAER)and estimated glomerular filtration rate(eGFR).However,clinically,DKD patients show normoalbuminuric diabetic kidney disease(NADKD)instead of clinical proteinuria.The old NADKD concept is no longer suitable and should be updated accordingly with the redefinition of normal proteinuria by NKF/FDA(National Kidney Foundation/Food and Drug Administration).Based on the relevant guidelines of DM and chronic kidney disease(CKD)and combined with the current situation of clinical research,the review described NADKD from the aspects of epidemiology,pathological mechanism,disease diagnosis,clinical characteristics and biomarkers,to arouse the new understanding of NADKD in the medical profession and pay attention to it.
作者
吴碧涛
安娜
杨渝伟
黄正红
俸家富
Wu Bitao;An Na;Yang Yuwei;Huang Zhenghong;Feng Jiafu(Department of Clinical Laboratory,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2023年第10期1663-1673,共11页
Chinese Journal of Preventive Medicine
基金
四川省科学技术厅科技支撑计划(2019YJ0701, 2021YJ0239)。
关键词
糖尿病
糖尿病肾脏疾病
正常白蛋白尿
Diabetes mellitus
Diabetic kidney disease
Normoalbuminuria
