Med. Pro Praxi 2008; 5(9): 313-316

Diabetická nefropatie

MUDr. Petr Bouček
Klinika diabetologie Centra diabetologie Institutu klinické a experimentální medicíny, Praha

Diabetická nefropatie (DN) dnes ve vyspělých zemích představuje hlavní příčinu vzniku chronického selhání ledvin. Ve svém přirozeném průběhu přechází DN od incipientní nefropatie s mikroalbuminurií do stadia manifestní nefropatie s proteinurií, hypertenzí a postupně narůstající renální insuficiencí. Při rozvoji DN dochází u nemocných obvykle také ke zhoršení metabolického vyrovnání diabetu a urychlení vývoje dalších mikrovaskulárních komplikací včetně diabetické retinopatie a neuropatie. Postižení ledvin je i významným rizikovým faktorem pro vznik aterosklerotických komplikací, které jsou odpovědné za vysokou mortalitu nemocných s DN. Klíčovými preventivně-léčebnými postupy u diabetické nefropatie jsou udržování optimální metabolické kompenzace a intenzivní léčba hypertenze s použitím inhibitorů systému renin-angiotenzin (ACE-inhibitory nebo AT-1 blokátory). V péči o nemocné s DN se osvědčuje aktivní multifaktoriální intervence se zaměřením na hlavní ovlivnitelné rizikové činitele vaskulárních komplikací.

Keywords: diabetes mellitus, diabetická nefropatie, hypertenze, ACE-inhibitory, AT-1 blokátory

Published: December 19, 2008  Show citation

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Bouček P. Diabetická nefropatie. Med. praxi. 2008;5(9):313-316.
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