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糖尿病性肾脏疾病

最后审阅: 6 Oct 2024
最后更新: 20 Sep 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 高血压
  • 视网膜病变的体征
  • 水肿
完整详情

其他诊断因素

  • 视力下降
  • 下肢麻木
  • 下肢疼痛
  • 全身症状(疾病进展期)
  • 足部改变
  • 体位性低血压
  • 皮肤改变
  • 肌肉萎缩
  • 苍白(肾小球滤过率下降所致)
  • 出血倾向(疾病进展期)
  • Kussmaul 呼吸(疾病进展期)
完整详情

危险因素

  • 持续高血糖
  • 高血压
  • 高血压和/或肾病家族史
  • 肥胖
  • 吸烟
  • 缺乏体力活动
  • 血脂异常
  • 高蛋白、脂肪和钠的摄入
完整详情

诊断性检查

首要检查

  • 尿液分析
  • 尿蛋白/肌酐比值 (ACR)
  • 血肌酐水平和肾小球滤过率 (GFR) 估算
  • 肾脏超声
完整详情

需考虑的检查

  • 白蛋白排泄率(AER)
  • 腹部 CT
  • 磁共振血管成像 (MRA)
  • 多普勒超声
  • 肾脏活检
完整详情

治疗流程

持续性治疗

1 型糖尿病合并肾病:未接受透析

2 型糖尿病合并肾病:未接受透析

接受腹膜透析或血液透析

撰稿人

作者

David J. Leehey, MD, FACP
David J. Leehey

Professor of Medicine

Division of Nephrology

Loyola University Medical Center

Maywood

IL

Associate Chief of Staff for Clinical Affairs and Education

Veterans Affairs Hospital

Hines

IL

利益声明

DJL declares that he has no competing interests. DJL is an author of references cited in this topic.

Irfan Moinuddin, MD
Irfan Moinuddin

Assistant Professor of Medicine

Southern Illinois University School of Medicine

Springfield

IL

利益声明

IM declares that he has no competing interests.

同行评议者

Rajiv Agarwal, MD

Professor of Medicine

Department of Medicine

Division of Nephrology

Indiana University School of Medicine

Indianapolis

IN

利益声明

RA declares that he has no competing interests.

Merlin C. Thomas, PhD

Associate Professor

Baker IDI Heart and Diabetes Institute

Melbourne

Australia

利益声明

MCT has received honoraria for speaking and educational sessions conducted by Sanofi-Aventis, Servier, Boehringer-Ingleheim, Abbott, Amgen, and Jansen-Cilag.

Damian Fogarty, BSc, MD, FRCP

Consultant/Senior Lecturer in Renal Medicine

Belfast City Hospital and Queen's University Belfast

Belfast City Hospital

Belfast

Northern Ireland

UK

利益声明

DF has no share options, research support, or employment with pharmaceutical companies. He has received one-time speaking fees to cover his time preparing educational talks in the broad areas of diabetic nephropathy and chronic kidney disease, promoting early recognition and evidence-based or best practice management.

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