Diabetic Kidney Disease: A Report From an ADA Consensus Conference

被引:360
作者
Tuttle, Katherine R. [1 ,2 ]
Bakris, George L. [3 ]
Bilous, Rudolf W. [4 ]
Chiang, Jane L. [5 ]
de Boer, Ian H. [6 ]
Goldstein-Fuchs, Jordi [7 ]
Hirsch, Irl B. [8 ]
Kalantar-Zadeh, Kamyar [9 ]
Narva, Andrew S. [10 ]
Navaneethan, Sankar D. [11 ]
Neumiller, Joshua J. [12 ]
Patel, Uptal D. [13 ,14 ]
Ratner, Robert E. [5 ,17 ]
Whaley-Connell, Adam T. [15 ,16 ]
Molitch, Mark E. [17 ]
机构
[1] Univ Washington, Sch Med, Seattle, WA USA
[2] Providence Hlth Care, Spokane, WA USA
[3] Univ Chicago Med, Comprehens Hypertens Ctr, Chicago, IL USA
[4] Newcastle Univ, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
[5] Amer Diabet Assoc, Alexandria, VA 22311 USA
[6] Univ Washington, Div Nephrol, Seattle, WA 98195 USA
[7] Sierra Nevada Nephrol Consultants, Reno, NV USA
[8] Univ Washington, Sch Med, Div Metab Endocrinol & Nutr, Seattle, WA USA
[9] Univ Calif Irvine, Sch Med, Irvine, CA 92717 USA
[10] NIDDK, NIH, Bethesda, MD USA
[11] Cleveland Clin, Dept Nephrol & Hypertens, Novick Ctr Clin & Translat Res, Glickman Urol & Kidney Inst, Cleveland, OH 44106 USA
[12] Washington State Univ, Coll Pharm, Dept Pharmacotherapy, Spokane, WA USA
[13] Duke Univ, Sch Med, Duke Clin Res Inst, Div Nephrol, Durham, NC USA
[14] Duke Univ, Sch Med, Duke Clin Res Inst, Div Pediat Nephrol, Durham, NC USA
[15] Harry S Truman Mem Vet Hosp, Columbia, MO 65201 USA
[16] Univ Missouri, Sch Med, Dept Internal Med, Div Nephrol & Hypertens, Columbia, MO USA
[17] Northwestern Univ, Feinberg Sch Med, Div Endocrinol Metab & Mol Med, Chicago, IL 60611 USA
基金
美国国家卫生研究院;
关键词
DIETARY-PROTEIN RESTRICTION; CLINICAL-PRACTICE GUIDELINE; GLOMERULAR-FILTRATION-RATE; HEMOGLOBIN A(1C) LEVELS; STAGE RENAL-DISEASE; GLYCEMIC CONTROL; LONG-TERM; REVERSE EPIDEMIOLOGY; BLOOD-PRESSURE; SEVERE HYPOGLYCEMIA;
D O I
10.2337/dc14-1296
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in type 2 diabetes. This overall increase in the number of people with diabetes has had a major impact on development of diabetic kidney disease (DKD), one of the most frequent complications of both types of diabetes. DKD is the leading cause of end-stage renal disease (ESRD), accounting for approximately 50% of cases in the developed world. Although incidence rates for ESRD attributable to DKD have recently stabilized, these rates continue to rise in high-risk groups such as middle-aged African Americans, Native Americans, and Hispanics. The costs of care for people with DKD are extraordinarily high. In the Medicare population alone, DKD-related expenditures among this mostly older group were nearly $25 billion in 2011. Due to the high human and societal costs, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation to appraise issues regarding patient management, highlighting current practices and new directions. Major topic areas in DKD included 1) identification and monitoring, 2) cardiovascular disease and management of dyslipidemia, 3) hypertension and use of renin-angiotensin-aldosterone system blockade and mineralocorticoid receptor blockade, 4) glycemia measurement, hypoglycemia, and drug therapies, 5) nutrition and general care in advanced-stage chronic kidney disease, 6) children and adolescents, and 7) multidisciplinary approaches and medical home models for health care delivery. This current state summary and research recommendations are designed to guide advances in care and the generation of new knowledge that will meaningfully improve life for people with DKD.
引用
收藏
页码:2864 / 2883
页数:20
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