蛋白尿
医学
微量白蛋白尿
蛋白尿
肾脏疾病
疾病
肾功能
糖尿病肾病
糖尿病
发病机制
内科学
透析
肾
心脏病学
内分泌学
作者
Sabrina Scilletta,Maurizio Di Marco,Nicoletta Miano,Agnese Filippello,Stefania Di Mauro,Alessandra Scamporrino,Marco Musmeci,Giuseppe Coppolino,Francesco Barbagallo,Giosiana Bosco,Roberto Scicali,Salvatore Piro,Francesco Purrello,Antonino Di Pino
出处
期刊:Biomolecules
[Multidisciplinary Digital Publishing Institute]
日期:2023-04-26
卷期号:13 (5): 752-752
被引量:53
摘要
The classic description of diabetic kidney disease (DKD) involves progressive stages of glomerular hyperfiltration, microalbuminuria, proteinuria, and a decline in the estimated glomerular filtration rate (eGFR), leading to dialysis. In recent years, this concept has been increasingly challenged as evidence suggests that DKD presents more heterogeneously. Large studies have revealed that eGFR decline may also occur independently from the development of albuminuria. This concept led to the identification of a new DKD phenotype: non-albuminuric DKD (eGFR < 60 mL/min/1.73 m2, absence of albuminuria), whose pathogenesis is still unknown. However, various hypotheses have been formulated, the most likely of which is the acute kidney injury-to-chronic kidney disease (CKD) transition, with prevalent tubular, rather than glomerular, damage (typically described in albuminuric DKD). Moreover, it is still debated which phenotype is associated with a higher cardiovascular risk, due to contrasting results available in the literature. Finally, much evidence has accumulated on the various classes of drugs with beneficial effects on DKD; however, there is a lack of studies analyzing the different effects of drugs on the various phenotypes of DKD. For this reason, there are still no specific guidelines for therapy in one phenotype rather than the other, generically referring to diabetic patients with CKD.
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