Normoalbuminuric diabetic kidney disease

Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease (ESRD). Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate (UAER) and glomerular filtration rate (GFR) are widely accepted as criteria for the diagnosis and clini...

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Bibliographic Details
Published in:Frontiers of medicine 2017-09, Vol.11 (3), p.310-318
Main Authors: Chen, Chao, Wang, Chang, Hu, Chun, Han, Yachun, Zhao, Li, Zhu, Xuejing, Xiao, Li, Sun, Lin
Format: Article
Language:English
Subjects:
Albuminuria - physiopathology
Biomarkers
Diabetes
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 2 - complications
diabetic kidney disease
Diabetic Nephropathies - diagnosis
Diabetic Nephropathies - epidemiology
Glomerular Filtration Rate
Humans
Kidney - pathology
Kidney diseases
Medicine
Medicine & Public Health
normoalbuminuria
Pathogenesis
renal impairment
Review
发病机制
早期诊断
病理特点
糖尿病肾病
肾功能不全
肾小球滤过率
肾脏疾病
蛋白尿
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Summary:Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease (ESRD). Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate (UAER) and glomerular filtration rate (GFR) are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages: normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus (DM) patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease (NADKD) or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.
ISSN:2095-0217
2095-0225
DOI:10.1007/s11684-017-0542-7