Derleme
Yıl 2018,
Cilt: 6 Sayı: 4, 20 - 25, 02.04.2018
Öz
Abstract
Diabetic kidney disease is one of the most common and serious chronic complications of type 1 diabetes. Microalbuminuria is one of the early findings of diabetic kidney disease and it is found to be associated with mortality. The abnormal increase of albumin excretion is due to microvascular lesions in glomerulicaused by long lasting hyperglycemia. The screening for microalbuminuria is recommended to be performed by measurement of urinary albumin to creatinineratio, after 5 years of diabetes diagnosis and repeated annually afterwards. Risk factors like long diabetes time, poor glycemic and blood pressure control, dyslipidemia and smoking increase the probability of overt diabetic kidney disease intype 1 diabetics with microalbuminuria. But the spontaneous regression of microalbuminuria to normoalbuminuria is also possible. The regulation of glycemiaand blood pressure, inhibition of renin-angiotensin-aldosterone-system and theavoidance of other risk factors are found to be effective in prevention or treatment of microalbuminuria.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1.Bakris GL, Molitch M. Microalbuminuria as a risk pre-dictor in diabetes: the continuing saga. Diabetes Care.2014; 37:867. 2.Newman DJ, Mattock MB, Dawnay AB, Kerry S,McGuire A, Yaqoob M, et al. Systematic review on uri-ne albumin testing for early detection of diabetic com-plications. Health Technol Assess. 2005 Aug;9(30): 163. 3.Papadopoulou-Marketou N, Chrousos GP, Kanaka-Gan-tenbein C. Diabetic nephropathy in type 1 diabetes: a re-view of early natural history, pathogenesis, and diagno-sis. Diabetes Metab Res Rev. 2017 Feb;33(2). 4.Nathan DM. The diabetes control and complications tri-al/epidemiology of diabetes interventions and complica-tions study at 30 years:overview. Diabetes Care.2014;37:9–16 5.Scandling JD, Myers BD. Glomerular size-selectivity andmicroalbuminuria in early diabetic glomerular disease.Kidney Int. 1992; 41:840. 6.Tamsma JT, van den Born J, Bruijn JA, Assmann KJ, Wee-ning JJ, Berden JH, et al. Expression of glomerular ext-racellular matrix components in human diabetic neph-ropathy: decrease of heparan sulphate in the glomeru-lar basement membrane. Diabetologia 1994; 37:313. 7.Osicka TM, Houlihan CA, Chan JG, Jerums G, ComperWD.. Albuminuria in patients with type 1 diabetes is di-rectly linked to changes in the lysosome-mediated deg-radation of albumin during renal passage. Diabetes.2000; 49:1579. 8.Russo LM, Sandoval RM, Campos SB, Molitoris BA,Comper WD, Brown D. Impaired tubular uptake expla-ins albuminuria in early diabetic nephropathy. J Am SocNephrol.2009; 20:489. 9.Palmer ND, Freedman BI. Insights into the genetic arc-hitecture ofdiabetic nephropathy. Curr Diab Rep .2012;12:42 3–431. 10.Seaquist ER, Goetz FC, Rich S, Barbosa J. Familial clus-tering of diabetickidney disease. Evidence for genetic sus-ceptibility to diabeticnephropathy. N Engl J Med.1989;320:1161–1165. 11.Pezzolesi MG, Poznik GD, Mychaleckyj JC, Paterson AD,Barati MT, Klein JB, et al. Genomewide associ-ationscan for diabetic nephropathy susceptibility genes in type1.Diabetes. 2009;58:1403–1410. 12.Sandholm N, Salem RM, McKnight AJ, Brennan EP,Forsblom C, Isakova T, et al. New susceptibility loci as-sociated with kidney disease in type 1 diabetes. PLoS Ge-net.2012;8. 13.Parving HH, Hommel E, Mathiesen E, Skøtt P, EdsbergB, Bahnsen M, et al. Prevalence of microalbuminuria,arterial hypertension, retinopathy and neuropathy in pa-tients with insulin dependent diabetes. Br Med J (ClinRes Ed).1988;296:156–160. 14.Warram JH, Gearin G, Laffel L, Krolewski AS. Effect ofduration of type I diabetes on the prevalence of stages ofdiabetic nephropathy defined by urinary albumin/creati-nine ratio. J Am Soc Nephrol. 1996; 7:930. 15.Microalbuminuria Collaborative Study Group. Micro-albuminuria in type I diabetic patients. Prevalence andclinical characteristics. Diabetes Care.1992; 15:495. 16.Thorn LM, Gordin D, Harjutsalo V, Hägg S, Masar R,Saraheimo M, et al. The presence and consequence ofnonalbuminuric chronic kidney disease in patients withtype 1 diabetes. Diabetes Care. 2015;38:2128–2133. 17.Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR,Kirkman MS, et al. Executive summary: guidelines andrecommendations for laboratory analysis in the diagno-sis and management of diabetes mellitus. Clin Chem.2011; 57:793. 18.Mogensen CE, Vestbo E, Poulsen PL, Christiansen C,Damsgaard EM, Eiskjaer H, et al. Microalbuminuria andpotential confounders. A review and some observationson variability of urinary albumin excretion. DiabetesCare. 1995; 18:572. 19.Zelmanovitz T, Gross JL, Oliveira JR, Paggi A, TatschM, Azevedo MJ.The receiver operating characteristicscurve in the evaluation of a random urine specimen asa screening test for diabetic nephropathy. Diabetes Care1997; 20:516. 20.American Diabetes Association. Microvascular Compli-cations and Foot Care: Standards of Medical Care inDiabetes -2018. Diabetes Care. 2018;41(Suppl.1):S105–S118 21.Kidney Disease: Improving Global Outcomes (KDIGO)CKD Work Group. KDIGO 2012 Clinical Practice Gui-deline for the Evaluation and Management of ChronicKidney Disease. Kidney Int Suppl 2013; 3:1. 22.Rossing P, Hougaard P, Parving HH. Risk factors for de-velopment of incipient and overt diabetic nephropathy intype 1 diabetic patients: a 10-year prospective observatio-nal study. Diabetes Care 2002; 25:859. 23.Sawicki PT, Didjur geit U, Mühlhauser I, Bender R, Hei-nemann L, Berger M. Smoking is associated with prog-ression of diabetic nephropathy. Diabetes Care.1994;17:126–131. 24.The Diabetes Control and Complications (DCCT) Re-search Group. Effect of intensive therapy on the deve-lopment and progression of diabetic nephropathy in theDiabetes Control and Complications Trial. Kidney Int.1995; 47:1703. 25.Parving HH, Oxenbøll B, Svendsen PA, Christiansen JS,Andersen AR. Early detection of patients at risk of de-veloping diabetic nephropathy. A longitudinal study ofurinary albumin excretion. Acta Endocri-nol.1982;100:550–555.14. 26.Mogensen CE, Christensen CK. Predicting diabetic neph-ropathy in insulindependent patients. N Engl J Med.1984;311:89–93.15. 27.Amin R, Widmer B, Prevost AT, Schwarze P, Cooper J,Edge J, et al. Risk of microalbuminuria and progressi-on to macroalbuminuria in a cohort with childhood on-set type 1 diabetes: prospective observational study. BMJ.2008;336:697–701. 28.Raile K, Galler A, Hofer S, Herbst A, Dunstheimer D,Busch P, et al. Diabetic nephropathy in 27,805 children,adolescents, and adults with type 1 diabetes: effect of dia-betes duration, A1C, hypertension, dyslipidemia, diabe-tes onset, and sex. Diabetes Care. 2007;30:2523–2528. 29.Perkins BA, Ficociello LH, Silva KH, Finkelstein DM,Warram JH, Krolewski AS. Regression of microalbumi-nuria in type 1 diabetes. N Engl J Med. 2003; 348:2285. 30.Giorgino F, Laviola L, Cavallo Perin P, Solnica B, Ful-ler J, Chaturvedi N. Factors associated with progressi-on to macroalbuminuria in microalbuminuric Type 1 dia-betic patients: the EURODIAB Prospective Complica-tions Study. Diabetologia. 2004; 47:1020. 31.Steinke JM1, Sinaiko AR, Kramer MS, Suissa S, ChaversBM, Mauer M. The early natural history of nephropathyin Type 1 Diabetes: III. Predictors of 5-year urinary al-bumin excretion rate patterns in initially normoalbumi-nuric patients. Diabetes. 2005; 54:2164. 32.ACE Inhibitors in Diabetic Nephropathy Trialist Gro-up. Should allpatients with type 1 diabetes mellitus andmicroalbuminuria receiveangiotensinconverting enzy-me inhibitors? A metaanalysis of individ-ual patient data.Ann Intern Med. 2001;134:370–379. 33.de Boer IH, Gao X, Cleary PA, Bebu I, Lachin JM, MolitchME, et al. Albuminuria Changes and Cardiovascular andRenal Outcomes in Type 1 Diabetes: The DCCT/EDICStudy. Clin J Am Soc Nephrol 2016; 11:1969. 34.Rosolowsky ET, Niewczas MA, Ficociello LH, PerkinsBA, Warram JH, Krolewski AS. Between hyperfiltrati-on and impairment: demystifying early renal functionalchanges in diabetic nephropathy. Diabetes Res Clin Pract.2008;82(Suppl 1):S46–S53. 35.Chavers BM, Bilous RW, Ellis EN, Steffes MW, MauerSM. Glomerular lesions and urinary albumin excretionin type I diabetes without overt proteinuria. N Engl JMed.1989; 320:966. 36.The Microalbuminuria Captopril Study Group. Captop-ril reduces the risk of nephropathy in IDDM patients withmicroalbuminuria. Diabetologia. 1996; 39:587. 37.The EUCLID Study Group. Randomised placebo-con-trolled trial of lisinopril in normotensive patients withinsulin-dependent diabetes and normoalbuminuria ormicroalbuminuria. Lancet. 1997; 349:1787. 38.Gross JL, de Azevedo MJ, Silveiro SP, Canani LH, Caramo-ri ML, Zelmanovitz T. Diabetic nephropathy: diagnosis, pre-vention, and treatment. Diabetes Care 2005; 28:164.
Yıl 2018,
Cilt: 6 Sayı: 4, 20 - 25, 02.04.2018
Öz
Öz
Diyabetik böbrek hastalığı; tip 1 diyabetin en sık ve en ağır kronik komplikasyonlarından biridir. Mikroalbuminüri de diyabetik böbrek hastalığının erken bulgularındandır ve tip 1 diyabet hastalarında artmış mortalite ile ilişkilidir. Albumin ekskresyonundaki anormal artış, uzun süreli hipergliseminin glomerüllerde sebep olduğu mikrovasküler hasar sonucu oluşmaktadır. Mikroalbuminüri taramasının tip 1 diyabette tanıdan 5 yıl sonra yıllık olarak ve idrarda albümin-kreatinin oranı ölçümü ile yapılması önerilmektedir. Tip 1 diyabetli ve mikroalbuminürisi olan hastaların uzun dönem takibi sonucunda aşikar nefropati gelişme ihtimalinin diyabet süresi ve kötü glisemik kontrol, dislipidemi, sigara, hipertansiyon gibi diğer risk faktörleri ile ilişkili olduğu gösterilmiştir. Ancak mikroalbuminürinin normoalbuminüriye spontan regresyonu da mümkündür. Mikroalbüminüriden korunmada veya normoalbuminüriye regresyonun sağlanmasında glisemi ve kan basıncı kontrolünün, renin-anjiyotensin-aldosteron-sisteminin inhibe edilmesinin ve diğer risk faktörlerinin bertaraf edilmesinin etkili olduğu gösterilmiştir.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1.Bakris GL, Molitch M. Microalbuminuria as a risk pre-dictor in diabetes: the continuing saga. Diabetes Care.2014; 37:867. 2.Newman DJ, Mattock MB, Dawnay AB, Kerry S,McGuire A, Yaqoob M, et al. Systematic review on uri-ne albumin testing for early detection of diabetic com-plications. Health Technol Assess. 2005 Aug;9(30): 163. 3.Papadopoulou-Marketou N, Chrousos GP, Kanaka-Gan-tenbein C. Diabetic nephropathy in type 1 diabetes: a re-view of early natural history, pathogenesis, and diagno-sis. Diabetes Metab Res Rev. 2017 Feb;33(2). 4.Nathan DM. The diabetes control and complications tri-al/epidemiology of diabetes interventions and complica-tions study at 30 years:overview. Diabetes Care.2014;37:9–16 5.Scandling JD, Myers BD. Glomerular size-selectivity andmicroalbuminuria in early diabetic glomerular disease.Kidney Int. 1992; 41:840. 6.Tamsma JT, van den Born J, Bruijn JA, Assmann KJ, Wee-ning JJ, Berden JH, et al. Expression of glomerular ext-racellular matrix components in human diabetic neph-ropathy: decrease of heparan sulphate in the glomeru-lar basement membrane. Diabetologia 1994; 37:313. 7.Osicka TM, Houlihan CA, Chan JG, Jerums G, ComperWD.. Albuminuria in patients with type 1 diabetes is di-rectly linked to changes in the lysosome-mediated deg-radation of albumin during renal passage. Diabetes.2000; 49:1579. 8.Russo LM, Sandoval RM, Campos SB, Molitoris BA,Comper WD, Brown D. Impaired tubular uptake expla-ins albuminuria in early diabetic nephropathy. J Am SocNephrol.2009; 20:489. 9.Palmer ND, Freedman BI. Insights into the genetic arc-hitecture ofdiabetic nephropathy. Curr Diab Rep .2012;12:42 3–431. 10.Seaquist ER, Goetz FC, Rich S, Barbosa J. Familial clus-tering of diabetickidney disease. Evidence for genetic sus-ceptibility to diabeticnephropathy. N Engl J Med.1989;320:1161–1165. 11.Pezzolesi MG, Poznik GD, Mychaleckyj JC, Paterson AD,Barati MT, Klein JB, et al. Genomewide associ-ationscan for diabetic nephropathy susceptibility genes in type1.Diabetes. 2009;58:1403–1410. 12.Sandholm N, Salem RM, McKnight AJ, Brennan EP,Forsblom C, Isakova T, et al. New susceptibility loci as-sociated with kidney disease in type 1 diabetes. PLoS Ge-net.2012;8. 13.Parving HH, Hommel E, Mathiesen E, Skøtt P, EdsbergB, Bahnsen M, et al. Prevalence of microalbuminuria,arterial hypertension, retinopathy and neuropathy in pa-tients with insulin dependent diabetes. Br Med J (ClinRes Ed).1988;296:156–160. 14.Warram JH, Gearin G, Laffel L, Krolewski AS. Effect ofduration of type I diabetes on the prevalence of stages ofdiabetic nephropathy defined by urinary albumin/creati-nine ratio. J Am Soc Nephrol. 1996; 7:930. 15.Microalbuminuria Collaborative Study Group. Micro-albuminuria in type I diabetic patients. Prevalence andclinical characteristics. Diabetes Care.1992; 15:495. 16.Thorn LM, Gordin D, Harjutsalo V, Hägg S, Masar R,Saraheimo M, et al. The presence and consequence ofnonalbuminuric chronic kidney disease in patients withtype 1 diabetes. Diabetes Care. 2015;38:2128–2133. 17.Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR,Kirkman MS, et al. Executive summary: guidelines andrecommendations for laboratory analysis in the diagno-sis and management of diabetes mellitus. Clin Chem.2011; 57:793. 18.Mogensen CE, Vestbo E, Poulsen PL, Christiansen C,Damsgaard EM, Eiskjaer H, et al. Microalbuminuria andpotential confounders. A review and some observationson variability of urinary albumin excretion. DiabetesCare. 1995; 18:572. 19.Zelmanovitz T, Gross JL, Oliveira JR, Paggi A, TatschM, Azevedo MJ.The receiver operating characteristicscurve in the evaluation of a random urine specimen asa screening test for diabetic nephropathy. Diabetes Care1997; 20:516. 20.American Diabetes Association. Microvascular Compli-cations and Foot Care: Standards of Medical Care inDiabetes -2018. Diabetes Care. 2018;41(Suppl.1):S105–S118 21.Kidney Disease: Improving Global Outcomes (KDIGO)CKD Work Group. KDIGO 2012 Clinical Practice Gui-deline for the Evaluation and Management of ChronicKidney Disease. Kidney Int Suppl 2013; 3:1. 22.Rossing P, Hougaard P, Parving HH. Risk factors for de-velopment of incipient and overt diabetic nephropathy intype 1 diabetic patients: a 10-year prospective observatio-nal study. Diabetes Care 2002; 25:859. 23.Sawicki PT, Didjur geit U, Mühlhauser I, Bender R, Hei-nemann L, Berger M. Smoking is associated with prog-ression of diabetic nephropathy. Diabetes Care.1994;17:126–131. 24.The Diabetes Control and Complications (DCCT) Re-search Group. Effect of intensive therapy on the deve-lopment and progression of diabetic nephropathy in theDiabetes Control and Complications Trial. Kidney Int.1995; 47:1703. 25.Parving HH, Oxenbøll B, Svendsen PA, Christiansen JS,Andersen AR. Early detection of patients at risk of de-veloping diabetic nephropathy. A longitudinal study ofurinary albumin excretion. Acta Endocri-nol.1982;100:550–555.14. 26.Mogensen CE, Christensen CK. Predicting diabetic neph-ropathy in insulindependent patients. N Engl J Med.1984;311:89–93.15. 27.Amin R, Widmer B, Prevost AT, Schwarze P, Cooper J,Edge J, et al. Risk of microalbuminuria and progressi-on to macroalbuminuria in a cohort with childhood on-set type 1 diabetes: prospective observational study. BMJ.2008;336:697–701. 28.Raile K, Galler A, Hofer S, Herbst A, Dunstheimer D,Busch P, et al. Diabetic nephropathy in 27,805 children,adolescents, and adults with type 1 diabetes: effect of dia-betes duration, A1C, hypertension, dyslipidemia, diabe-tes onset, and sex. Diabetes Care. 2007;30:2523–2528. 29.Perkins BA, Ficociello LH, Silva KH, Finkelstein DM,Warram JH, Krolewski AS. Regression of microalbumi-nuria in type 1 diabetes. N Engl J Med. 2003; 348:2285. 30.Giorgino F, Laviola L, Cavallo Perin P, Solnica B, Ful-ler J, Chaturvedi N. Factors associated with progressi-on to macroalbuminuria in microalbuminuric Type 1 dia-betic patients: the EURODIAB Prospective Complica-tions Study. Diabetologia. 2004; 47:1020. 31.Steinke JM1, Sinaiko AR, Kramer MS, Suissa S, ChaversBM, Mauer M. The early natural history of nephropathyin Type 1 Diabetes: III. Predictors of 5-year urinary al-bumin excretion rate patterns in initially normoalbumi-nuric patients. Diabetes. 2005; 54:2164. 32.ACE Inhibitors in Diabetic Nephropathy Trialist Gro-up. Should allpatients with type 1 diabetes mellitus andmicroalbuminuria receiveangiotensinconverting enzy-me inhibitors? A metaanalysis of individ-ual patient data.Ann Intern Med. 2001;134:370–379. 33.de Boer IH, Gao X, Cleary PA, Bebu I, Lachin JM, MolitchME, et al. Albuminuria Changes and Cardiovascular andRenal Outcomes in Type 1 Diabetes: The DCCT/EDICStudy. Clin J Am Soc Nephrol 2016; 11:1969. 34.Rosolowsky ET, Niewczas MA, Ficociello LH, PerkinsBA, Warram JH, Krolewski AS. Between hyperfiltrati-on and impairment: demystifying early renal functionalchanges in diabetic nephropathy. Diabetes Res Clin Pract.2008;82(Suppl 1):S46–S53. 35.Chavers BM, Bilous RW, Ellis EN, Steffes MW, MauerSM. Glomerular lesions and urinary albumin excretionin type I diabetes without overt proteinuria. N Engl JMed.1989; 320:966. 36.The Microalbuminuria Captopril Study Group. Captop-ril reduces the risk of nephropathy in IDDM patients withmicroalbuminuria. Diabetologia. 1996; 39:587. 37.The EUCLID Study Group. Randomised placebo-con-trolled trial of lisinopril in normotensive patients withinsulin-dependent diabetes and normoalbuminuria ormicroalbuminuria. Lancet. 1997; 349:1787. 38.Gross JL, de Azevedo MJ, Silveiro SP, Canani LH, Caramo-ri ML, Zelmanovitz T. Diabetic nephropathy: diagnosis, pre-vention, and treatment. Diabetes Care 2005; 28:164.
Toplam 1 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Makaleler 1 |
| Yazarlar | |
| Yayımlanma Tarihi | 2 Nisan 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 6 Sayı: 4 |
