切换至 "中华医学电子期刊资源库"

中华肾病研究电子杂志 ›› 2013, Vol. 02 ›› Issue (03) : 138 -141. doi: 10.3877/cma.j.issn.2095-3216.2013.03.007

专家论坛

糖尿病及糖尿病肾病合并急性肾损伤的诊断和治疗
汪年松1,(), 李军辉1   
  1. 1.200233 上海交通大学附属第六人民医院肾内科
  • 出版日期:2013-06-15
  • 通信作者: 汪年松
  • 基金资助:
    现担任上海医学会肾脏病学分会副主任委员、中国中西医结合肾病学会常委、中国医师协会肾病分会委员、中国医院管理协会血液净化学会委员、全国人工肝和血液净化学组委员、全国血液净化专家组委员及上海市中西医结合肾病学会常委,《中国中西医结合肾病杂志》常务编委等。近年来先后主持和参与国家自然科学基金、卫生部科研基金、上海市科委重大攻关课题及上海市自然科研基金等多项课题的研究工作。已在SCI发表论文40余篇、主编专著3部,参编专著6部。国家自然科学基金(81270824)

Diagnosis and treatment of diabetes and diabetic nephropathy in patients with acute kidney injury

Nian-song WANG1,(), Jun-hui LI1   

  1. 1.Department of Nephrology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Published:2013-06-15
  • Corresponding author: Nian-song WANG
引用本文:

汪年松, 李军辉. 糖尿病及糖尿病肾病合并急性肾损伤的诊断和治疗[J/OL]. 中华肾病研究电子杂志, 2013, 02(03): 138-141.

Nian-song WANG, Jun-hui LI. Diagnosis and treatment of diabetes and diabetic nephropathy in patients with acute kidney injury[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2013, 02(03): 138-141.

糖尿病肾病是糖尿病最常见的微血管并发症,也是临床常见病、多发病,容易发生急性肾损伤,若不积极治疗,预后不佳。糖尿病合并AKI的常见原因:高渗性非酮症糖尿病昏迷,糖尿病酮症酸中毒,糖尿病肾病,非糖尿病性肾脏疾病及糖尿病患者使用对比剂所致AKI等。现就糖尿病和糖尿病肾病合并急性肾损伤的流行病学、常见原因、诊断及治疗等做一阐述。

Diabetic nephropathy (DN)is the most common microvascular complications of diabetes, which is prone to acute kidney injury (AKI). It is also a common and frequently-occurring disease. If DN is not treated actively, its prognosis is poor. The frequent causes of AKI in diabetes include hyperosmolar nonketotic diabetic coma, diabetic ketoacidosis, DN, non-diabetic renal diseases,and contrast-induced AKI in patients with diabetes. In this paper, a review will be elaborated on the epidemiology, common causes, diagnosis and treatment of diabetes as well as DN complicated with AKI.

1
Girman CJ, Kou TD, Brodovicz K, et al. Risk of acute renal failure in patients with Type 2 diabetes mellitus [J]. Diabet Med,2012, 29(5): 614-621.
2
Yang W, Lu J, Weng J, et al. Prevalence of diabetes among men and women in China [J]. N Engl J Med, 2010, 362(12): 1090-1101.
3
Kitabchi AE, Miles JM, Umpierrez GE, et al. Hyperglycemic crisis in adult patients with diabetes [J]. Diabetes Care, 2009,32(7): 1335-1343.
4
Chen HF, Wang CY, Lee HY, et al. Short-term case fatality rate and associated factors among inpatients with diabetic ketoacidosis and hyperglycemic hyperosmolar state:a hospital-based analysis over a 15-year period [J]. Intern Med, 2010, 49(8): 729-737.
5
Toprak O, Cirit M, Ersoy R, et al. New-onset type II diabetes mellitus,hyperosmolar non-ketotic coma, rhabdomyolysis and acute renal failure in a patient treated with sulpiride [J]. Nephrol Dial Transplant, 2005, 20(3): 662-663.
6
白秀燕, 闰蓓, 陈丽, 等. 糖尿病急性代谢并发症与非创伤性横纹肌溶解症. 国际内分泌代谢杂志 [J]. 2007, 27(3): 178-180.
7
Al-Matrafi J, Vethamuthu J, Feber J, et al. Severe acute renal failure in a patient with diabetic ketoacidosis [J]. Saudi J Kidney Dis Transpl, 2009, 20(5): 831-834.
8
岳荣铮, 张凌, 刘芳, 等. 连续性血液净化治疗糖尿病肾病酮症酸中毒合并急性肾损伤临床分析[J]. 四川大学学报(医学版), 2012, 43(3): 434-437.
9
Hollander AS, Olney RC, Blackett PR, et al. Fatal malignant hyperthermia-like syndrome with rhabdomyolysis complicating the presentation of diabetes mellitus in adolescent males [J].Pediatrics, 2003, 111 (6 Pt 1): 1447-1452.
10
Huerta AL, Varon J, Marik PE, et al. Bench-to-bedside review:Rhabdomyolysisan overview for clinicians [J]. Crit Care, 2005,9(2): 158-169.
11
张军, 魏崇一. 持续低效每日血液透析滤过治疗糖尿病肾病合并急性肾损伤的疗效观察 [J]. 国际移植与血液净化杂志,2012, 9(5): 27-29.
12
孙世澜. 糖尿病肾病相关的急性肾损伤[G]. 中华医学会老年分会第九届全国肾脏病学术会议论文汇编, 武汉, 2011.
13
Das U, Dakshinamurty KV, Prayaga A, et al. Nondiabetic kidney disease in type 2 diabetic patients: A single center experience [J].Indian J Nephrol, 2012, 22 (5): 358-362.
14
杜勇, 杨念生, 李幼姬, 等. 2型糖尿病患者合并非糖尿病肾损害的临床病理分析 [J]. 中华糖尿病杂志, 2004, 12(6): 409-412.
15
任雯雯, 李文歌, 邹古明, 等. 202例糖尿病患者并发非糖尿病性肾损害的临床病理 [J]. 中华肾脏病杂志, 2011, 27(10): 720-723.
16
Mehran R, Nikolsky E. Contrast-induced nephropathy: Definition,epidemiology, and patient at risk [J]. Kidney Int, 2006, 69(1000):S11-S15.
17
Nash K, Hafeez A, Hou S, et al. Hospital-acquired renal insufficiency [J]. Am J Kidney Dis, 2002, 39(5): 930-936.
18
李军辉, 宣昶有, 简桂花, 等. KIM-1检测冠脉造影后对比剂肾病的前瞻性研究[J]. 中华全科医学, 2012, 10(10): 1513-1515.
19
Weisbord SD, Palevsky PM, et al. Contrast-induced acute kidney injury: short- and long-term implications [J]. Semin Nephrol,2011, 31(3): 300-309.
20
Pakfetrat M, Nikoo MH, Malekmakan L, et al. Comparison of risk factors for contrast-induced acute kidney injury between patients with and without diabetes [J]. Hemodial Int, 2010, 14(4):387-392.
21
李军辉, 王锋, 王强庆, 等. 慢性肾病并发急性肾衰竭75例临床分析[J]. 上海医学, 2009, 32(3): 218-220.
22
Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin theraphy in critically ill patients [J]. N Engl J Med, 2001, 345(19):1359-1367.
23
Ronco C, Bellomo R, Homel P, et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial [J]. Lancet, 2000,356(9223): 26-30.
24
Joannes-BO, Honoré PM, Perez P, et al. High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial [J]. Intensive Care Med, 2013, 39(9): 1535-1546.
25
Ponce D, Berbel MN, Regina GC, et al. High-volume peritoneal dialysis in acute kidney injury: indications and limitations [J].Clin J Am SocNephrol, 2012, 7(6): 887-894.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 778-784.
[3] 曹雯佳, 刘学兵, 罗安果, 钟释敏, 邓岚, 王玉琳, 李赵欢. 超声矢量血流成像对2型糖尿病患者颈动脉壁剪切应力的研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(07): 709-717.
[4] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[5] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[6] 刘柏隆, 周祥福. 压力性尿失禁阶梯治疗的项目介绍[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 125-125.
[7] 刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[8] 吴天宇, 刘子璇, 杨浦鑫, 贾思明, 丁凯, 程晓东, 李泳龙, 陈伟, 吕红芝, 张奇. 腰椎间盘突出症保守治疗进展[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 379-384.
[9] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[10] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[11] 王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
[12] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[13] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[14] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
[15] 崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
阅读次数
全文


摘要