Diabetic nephropathy: diagnosis, prevention and treatment

Diyabetik nefropati (DN) hem tip 1 hem tip 2 Diabetes Mellitus (DM)'da görülen mikrovasküler bir komplikasyon olup sıklığı tüm dünyada artmaktadır. Patogenezinde hemodinamik, metabolik ve genetik faktörler sorumlu tutulmaktadır. İlk bulgusu mikroalbuminüri (30-300 mg/gün veya 20-200 µ/dk). Mikroalbuminüri için tarama Tip 1 DM'de tanıdan 5 yıl sonra, tip 2 DM de tanı konduğunda yılda bir kere yapılmalıdır. DN oluşumunda ve ilerlemesinde hiperglisemi, hipertansiyon, sigara içme, yüksek proteinli diyet, hiperlipidemi, cinsiyet, ırk, obezite ve genetik yatkınlık bağımsız risk faktörleridir. İyi glisemik kontrol (HbA1c < 7%), hipertansiyonun tedavisi (< 130/80 mmHG veya proteinüri > 1 gr/gün ise < 125/75 mmHg), hiperlipidemi tedavisi (LDL < 100 mg/dl) ve düşük proteinli diyet ile mikroalbuminüri gelişimi ve DN'nin ilerlemesini engelleyecek etkili tedavilerdir

Diyabetik nefropati: tanı, önleme ve tedavisi

Diabetic Nephropathy (DN) is a microvascular complication seen in both type 1 and 2 Diabetes Mellitus (DM) and worldwide incidince is increasing. Hemodynamic, metabolic and genetic factors are responsible take part in the pathogenesis. First finding is microalbuminuria (30-300 mg/day or 20-200 µ/min.). Screening for microalbuminuria should be performed once a year, starting 5 years after diagnosis in type 1 DM and at diagnosis in type 2 DM patients. Hyperglycemia, hypertension, smoking, high dietary protein, hyperlipidemia, sex, race, obesity and genetic tendency were identified as independent risk factors in the development and progression of DN. Good glycemic control (HbA1c < 7%), treating hypertension (< 130/80 mmHg or < 125/75 mmHg if proteinuria > 1.0 g/day), treating dyslipidemia (LDL cholesterol <100 mg/dl) and low dietary protein are effective treatments for preventing the development of microalbuminuria and progression of nephropathy

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