糖尿病正常白蛋白尿而肾功能不全的研究进展

Update of normoalbuminuric renal insufficiency in diabetes

糖尿病肾病是导致终末期。肾病的一个主要原因，而微量白蛋白尿是糖尿病肾病的一个重要临床表现。近期研究表明，正常白蛋白尿而肾功能不全的情况在糖尿病患者中并不少见，尤其是2型糖尿病。正常白蛋白尿而肾功能不全的发病机制可能与肾间质纤维化、缺血性血管疾病以及尿液中尿白蛋白碎片的比例增加有关。其临床特点为女性比例较高，糖尿病病程较短，高血压发病率更低等。正常白蛋白尿而肾功能不全的病理特点为整体肾小球硬化。目前关于正常白蛋白尿而。肾功能不全的治疗与白蛋白尿。肾功能不全的患者并没有什么不同，而其预后可能比后者更好。

Diabetic nephropathy is a leading cause of end-stage renal disease and microalbuminuria has been considered as the first clinical sign of diabetic nephropathy. However, recent studies demonstrated that normoalbuminuric renal insufficiency is not uncommon for diabetic patients, especially in type 2 diabetes mellitus. The pathogenesis of normoalbuminuric renal insufficiency is related to renal interstitial fibrosis and ischemic vascular disease and increase of proportion of protein fragments in urine. Its clinical characteristics is associated with a higher proportion of female, a shorter duration of diabetes, lower prevalence of hypertension. The pathological characteristics associated with normoalbuminuric renal insufficiency in diabetes is global glomerular sclerosis. The treatment of normoalbuminuric renal insufficiency is similar to the treatment of albuminuric renal insufficiency and studies have shown that normal albuminuria renal insufficiency patients may have a better outcome compared to the latter.