Diabetes und Niere – Diabetische Nephropathie auf dem Vormarsch

Die diabetische Nephropathie ist neben der vaskulären Nephropathie die häufigste Nierenerkrankung in den entwickelten Industriestaaten. Die wichtigsten Faktoren für ihre Entstehung sind genetische Prädisposition, arterielle Hypertonie und Hyperglykämie. Eine Prävention ist nur durch eine frühzeitige Optimierung von Blutdruck und Blutzucker – praktisch unmittelbar nach Stellung der Diabetesdiagnose möglich. Für die Progressionshemmung hat sich die Blutdruckoptimierung als entscheidend erwiesen, eine normnahe Blutzuckereinstellung ist dabei eher von nachgeordneter Bedeutung.

Diabetic nephropathy has become the most common cause of end stage renal disease in the industrialized countries. Genetic background, hyperglycemia and hypertension are important causative factors, whereas the latter one is also responsible for disease progression. An early optimal treatment of hypertension and hyperglycemia accompanied by life style modification are the best therapeutic strategies to prevent diabetic kidney damage. Once diabetic nephropathy has been occurred, an optimal blood pressure control is mandatory and its effect is superior over blood glucose control.

Key words

diabetic nephropathy - microalbuminuria - oxidative stress - diabetes mellitus

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1 Diabetes Control and Complications Trial

2 United Kingdom Prospective Diabetes Study

3 Action to Control Cardiovascular Risk in Diabetes

4 Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation

5 Veterans Affairs Diabetes Trial

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