| Theme | Importance of Preservative Management in Chronic Renal Failure -- for a Better Dialysis | |
|---|---|---|
| Title | Diabetic nephropathy | |
| Publish Date | 2004/06 | |
| Author | Yasushi Yamasaki | Okayama University Graduate School of Medicine and Dentistry, Department of Medicine and Clinical Science |
| Author | Hirofumi Makino | Okayama University Graduate School of Medicine and Dentistry, Department of Medicine and Clinical Science |
| [ Summary ] | Diabetic nephropathy (DN) is characterized by an insidious progression over decades, and the clinical stages of DN are classified by the presence of microalbuminuria or overt albuminuria and decreased renal functioning. Intensive blood sugar control is effective in preventing development and progression of DN, particularly in the early stages of DN. Intensive blood pressure control and usage of angiotensin-converting-enzyme inhibitors and/or angiotensin type 1-receptor blockers have the advantage of being able to slow the progression of renal failure and to decrease the number of cardiovascular events for advanced stage patients. The effectiveness of protein restriction on the progression of DN is still controversial, but mild to moderate protein restriction is recommended for patients with reduced renal functioning. The prognosis for advanced DN patients is poor due to cardiovascular complications. Intensive care, including blood sugar and blood pressure regulation, is strongly recommended from the early stages of DN. | |