肾脏病理对糖尿病肾病诊断与预后的新思考

Novel thinking of renal pathology on the diagnosis and prognosis of diabetic nephropathy

糖尿病(diabetes mellitus, DM)是人类健康面临的巨大挑战,而糖尿病肾病(diabetic nephropathy, DN)是其最重要的并发症之一,也是导致终末期肾病(end stage renal disease, ESRD)的主要原因。早期诊断和治疗是改善DN患者预后的关键。然而,仅凭临床表现与生化指标来诊断DN存在局限性,糖尿病合并肾损伤患者的病理表现具有多样性和复杂性,非糖尿病肾病(non-diabetic renal disease, NDRD)的比例并不少见。肾穿刺活检作为一种新的较为安全的手段是诊断DN的金标准,被推荐用于DN的诊断与鉴别诊断。本文就目前发表的临床指标与病理指标对DN诊断与预后的临床研究做一综述,为临床医生提供参考信息。

Diabetes mellitus(DM)has been a great challenge to human health.is As one of the most important complications,diabetic nephropathy(DN)is a major cause of end-stage renal disease(ESRD).Early diagnosis and treatment are essential for ameliorating the prognosis of DN patients.However,it is limited to diagnosing DN only by clinical manifestations and biochemical parameters.The pathological manifestations of diabetics with renal injury are diverse and complex and the proportion of non-diabetic nephropathy(NDRD)is quite common.As a new and safer tool,renal biopsy is a gold diagnostic standard for DN.So it is recommended for the diagnosis and differential diagnosis of DN.Here the relevant clinical and pathological parameters of DN were reviewed for practicing references.