Diabetic Kidney Disease: A Report From an ADA Consensus Conference

作者：Katherine R. Tuttle, George L. Bakris, Rudolf W. Bilous, Jane L. Chiang, Ian H. de Boer, Jordi Goldstein‐Fuchs, Irl B. Hirsch, Kamyar Kalantar‐Zadeh, Andrew S. Narva, Sankar D. Navaneethan, Joshua J. Neumiller, Uptal D. Patel, Robert E. Ratner, Adam Whaley‐Connell, Mark E. Molitch · 发表于：Diabetes Care · 年份：2014 · DOI：10.2337/dc14-1296 · 被引用次数：1146 · 研究领域：Chronic Kidney Disease and Diabetes、Dialysis and Renal Disease Management、Diabetes Treatment and Management

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 therap...