最近审阅: 4 十一月 2020
最近更新: 22 五月 2020

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

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
  • 皮肤苍白(GFR 下降时)
  • 出血倾向(疾病进展期)
  • Kussmaul 呼吸(疾病进展期)

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

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
更多 首要检查

需考虑的检查

  • 白蛋白排泄率(AER)
  • 腹部 CT
  • 磁共振血管造影术
  • 多普勒超声
  • 肾脏活检
更多 需考虑的检查

治疗流程

撰稿人

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.

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.

同行评议者展开全部内容

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.

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.

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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