Die diabetische Nephropathie im Alter – Ist das therapeutisch Machbare auch erstrebenswert?

Die deutsche Bevölkerung wird zunehmend älter. Auch gibt es immer mehr Diabetes mellitus im Alter. Die diabetische Nephropathie ist die Hauptursache für Nierenversagen. Der rechtzeitigen Diagnostik mittels Mikroalbuminurie–Nachweis kommt neben der Bestimmung der Nierenfunktion entscheidende Bedeutung zu. Grundlagen der Behandlung sind die Kochsalzreduktion sowie die konsequente Blutdruckeinstellung. Die rechtzeitige Überweisung zum Nephrologen nutzt den Betroffenen. Die Nierenersatztherapie im Alter unterscheidet sich nicht wesentlich von der bei jüngeren Betroffenen. Entscheidend für die Behandlung der diabetischen Nephropathie ist die konsequente Vorbeugung.

The German population is growing in age. The incidence of diabetes mellitus in this population is growing, too. The diabetic nephropathy is the main cause for end stage renal failure. Important for the future development of this disease is the estimation of the kidney function and urinanalysis for microalbuminuria. Sodium restriction and a consistent antihypertensive therapy are the basis. The patient benefits from early referral to the nephrologist. Renal replacement therapy does not differ between younger and elder people. Prophylaxis is fundamental for the therapy of diabetic nephropathy.

Key words

Nephropathy - diabetes - old age microalbuminuria - sodium restriction - antihypertensive therapy

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