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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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Published in: | Frontiers of medicine 2017-09, Vol.11 (3), p.310-318 |
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description | 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. |
doi_str_mv | 10.1007/s11684-017-0542-7 |
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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.</description><identifier>ISSN: 2095-0217</identifier><identifier>EISSN: 2095-0225</identifier><identifier>DOI: 10.1007/s11684-017-0542-7</identifier><identifier>PMID: 28721497</identifier><language>eng</language><publisher>Beijing: Higher Education Press</publisher><subject>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</subject><ispartof>Frontiers of medicine, 2017-09, Vol.11 (3), p.310-318</ispartof><rights>Copyright reserved, 2017, Higher Education Press and Springer-Verlag Berlin Heidelberg</rights><rights>Higher Education Press and Springer-Verlag GmbH Germany 2017</rights><rights>Frontiers of Medicine is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-c4b09b686b4bca4d5e565650101e844ebe595454e16d0ee3935f17ab4e11b2e93</citedby><cites>FETCH-LOGICAL-c448t-c4b09b686b4bca4d5e565650101e844ebe595454e16d0ee3935f17ab4e11b2e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/71235X/71235X.jpg</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28721497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Chao</creatorcontrib><creatorcontrib>Wang, Chang</creatorcontrib><creatorcontrib>Hu, Chun</creatorcontrib><creatorcontrib>Han, Yachun</creatorcontrib><creatorcontrib>Zhao, Li</creatorcontrib><creatorcontrib>Zhu, Xuejing</creatorcontrib><creatorcontrib>Xiao, Li</creatorcontrib><creatorcontrib>Sun, Lin</creatorcontrib><title>Normoalbuminuric diabetic kidney disease</title><title>Frontiers of medicine</title><addtitle>Front. Med</addtitle><addtitle>Frontiers of Medicine</addtitle><description>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.</description><subject>Albuminuria - physiopathology</subject><subject>Biomarkers</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>diabetic kidney disease</subject><subject>Diabetic Nephropathies - diagnosis</subject><subject>Diabetic Nephropathies - epidemiology</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney - pathology</subject><subject>Kidney diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>normoalbuminuria</subject><subject>Pathogenesis</subject><subject>renal impairment</subject><subject>Review</subject><subject>发病机制</subject><subject>早期诊断</subject><subject>病理特点</subject><subject>糖尿病肾病</subject><subject>肾功能不全</subject><subject>肾小球滤过率</subject><subject>肾脏疾病</subject><subject>蛋白尿</subject><issn>2095-0217</issn><issn>2095-0225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9UMtOwzAQtBCIVqUfwAUhuPQS8Dp2HB8R4iVVcIGzFSeb1iWP1k4O_XtcpVSIQ23Ju7ZnZneHkEugd0CpvPcAScojCjKigrNInpAxo0pElDFxeshBjsjU-xUNiycglTonI5ZKBlzJMZm9t65us8r0tW16Z_PrwmYGu5B826LBbbh7zDxekLMyqzxO93FCvp6fPh9fo_nHy9vjwzzKOU-7cBqqTJImhps844VAkYRNgQKmnKNBoQQXHCEpKGKsYlGCzEx4AMNQxRMyG3TXrt306DtdW59jVWUNtr3XoBiNFQ_DB-jtP-iq7V0TuguoWICiQu1QMKBy13rvsNRrZ-vMbTVQvXNSD07q4KTeOall4FztlXtTY3Fg_PoWAGwA-PDVLND9KX1ENR1IS7tYosNi7dB7Xbq26Sy649Sb_RDLtllsQslDT4mMgco0hB-G95kE</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Chen, Chao</creator><creator>Wang, Chang</creator><creator>Hu, Chun</creator><creator>Han, Yachun</creator><creator>Zhao, Li</creator><creator>Zhu, Xuejing</creator><creator>Xiao, Li</creator><creator>Sun, Lin</creator><general>Higher Education Press</general><general>Springer Nature B.V</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>W91</scope><scope>~WA</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170901</creationdate><title>Normoalbuminuric diabetic kidney disease</title><author>Chen, Chao ; Wang, Chang ; Hu, Chun ; Han, Yachun ; Zhao, Li ; Zhu, Xuejing ; Xiao, Li ; Sun, Lin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-c4b09b686b4bca4d5e565650101e844ebe595454e16d0ee3935f17ab4e11b2e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Albuminuria - physiopathology</topic><topic>Biomarkers</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>diabetic kidney disease</topic><topic>Diabetic Nephropathies - diagnosis</topic><topic>Diabetic Nephropathies - epidemiology</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney - pathology</topic><topic>Kidney diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>normoalbuminuria</topic><topic>Pathogenesis</topic><topic>renal impairment</topic><topic>Review</topic><topic>发病机制</topic><topic>早期诊断</topic><topic>病理特点</topic><topic>糖尿病肾病</topic><topic>肾功能不全</topic><topic>肾小球滤过率</topic><topic>肾脏疾病</topic><topic>蛋白尿</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Chao</creatorcontrib><creatorcontrib>Wang, Chang</creatorcontrib><creatorcontrib>Hu, Chun</creatorcontrib><creatorcontrib>Han, Yachun</creatorcontrib><creatorcontrib>Zhao, Li</creatorcontrib><creatorcontrib>Zhu, Xuejing</creatorcontrib><creatorcontrib>Xiao, Li</creatorcontrib><creatorcontrib>Sun, Lin</creatorcontrib><collection>维普_期刊</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>维普中文期刊数据库</collection><collection>中文科技期刊数据库-医药卫生</collection><collection>中文科技期刊数据库- 镜像站点</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection (ProQuest Medical & Health Databases)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Frontiers of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Chao</au><au>Wang, Chang</au><au>Hu, Chun</au><au>Han, Yachun</au><au>Zhao, Li</au><au>Zhu, Xuejing</au><au>Xiao, Li</au><au>Sun, Lin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Normoalbuminuric diabetic kidney disease</atitle><jtitle>Frontiers of medicine</jtitle><stitle>Front. 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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.</abstract><cop>Beijing</cop><pub>Higher Education Press</pub><pmid>28721497</pmid><doi>10.1007/s11684-017-0542-7</doi><tpages>9</tpages></addata></record> |
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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 |
title | Normoalbuminuric diabetic kidney disease |
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