Diabetes und Niere

Zusammenfassung

Die diabetische Nephropathie ist weltweit die führende Ursache des terminalen Nierenversagens. Zur Basisdiagnostik ist eine Bestimmung der Urinalbuminausscheidung und der (geschätzten) Kreatininclearence erforderlich. Liegt eine diabetische Nephropathie vor, sollte auf Grund des dann stark erhöhten kardio-vaskulären Risikos eine umfangreiche Umfelddiagnostik erfolgen. Therapeutisch steht beim Typ 1 Diabetes die Diabetesbehandlung im Zentrum. Bei eingetretener Niereninsuffizienz und beim Typ 2 Diabetes sind eine multifaktorielle Therapie mit Ernährungstherapie, Diabeteseinstellung, Blutdrucksenkung, Raucherentwöhnung, ASS und medikamentöser Lipidtherapie erforderlich. Spezielle Medikamente zur Behandlung der diabetischen Nierenschädigung stehen bisher nicht zur Verfügung.

Abstract

Diabetic nephropathy is the leading cause of end-stage renal disease all over the world. Diagnosis is confirmed by measuring urin albumin excretion and calculated renal function (eGFR). Once the diagnosis is confirmed there should be a search for confounding cardiovascular risk factors and even established cardiovascular disease because of the associated high cardiovascular risk. In type 1 diabetes metabolic control is the main issue. In case of renal impairment and in patients with type 2 diabetes a multifactorial approach is necessary, which consists of dietary advise, metabolic control, lowering elevated blood-pressure, cessation of smoking, ASS and lipid-lowering drug-therapy. Special drugs for the treatment of diabetes-induced renal disease are not available.

Schlüsselwörter

diabetische Nephropathie - Umfelddiagnostik - kardiovaskuläres Risiko - multifaktorielle Therapie

Keywords

diabetic nephropathy - stages of diabetic kidney disease - cardiovascular risk - multifactorial intervention

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