Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital

Prognosis and treatment of diabetic nephropathy: Recent advances and perspectives

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. A large remaining potential in lipid-lowering drug treatment in the type 2 diabetes population: A Danish nationwide cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Approximately 20 to 40% of patients with type 1 or type 2 diabetes develop diabetic kidney disease. It is a clinical syndrome characterized by persistent albuminuria (>300mg/24h, or 300mg/g creatinine), a relentless decline in glomerular filtration rate, raised arterial blood pressure and enhanced cardiovascular morbidity and mortality. The natural course of classical diabetic nephropathy is initially microalbuminuria or moderately increased urine albumin excretion (30-300mg/g creatinine). Untreated microalbuminuria may then rise gradually, reaching severely increased albuminuric (macroalbuminuria) over 5 to 15 years. Glomerular filtration rate then begins to decline and end-stage renal failure is reached without treatment in 5 to 7 years. Regular, systematic screening for diabetic kidney disease is needed to identify patients at risk for, or with presymptomatic stages of diabetic kidney disease. Multifactorial intervention targeting glucose, lipids and blood pressure including blockade of renin angiotensin system and lifestyle, has improved renal and cardiovascular prognosis and reduced mortality with 50%. Recent data suggest beneficial pleiotropic effects on renal endpoint with new glucose lowering agents. It is also being investigated if blocking aldosterone could be an option as a potential new treatment. Thus, although diabetic nephropathy remains a major burden, prognosis has improved and new options for further improvements are currently tested in phase 3 clinical renal outcome studies.

TidsskriftNephrologie & Therapeutique
Vol/bind14 Suppl 1
Sider (fra-til)S31-S37
StatusUdgivet - apr. 2018

ID: 53599390