Diabetes mellitus and microalbuminuria


Authors: D. Krusová
Authors‘ workplace: II. interní klinika LF MU a FN u sv. Anny Brno, přednosta doc. MUDr. Miroslav Souček, CSc.
Published in: Vnitř Lék 2007; 53(12): 1310-1318
Category: Review

Overview

Mikroalbuminurie je považována za nezávislý prediktor kardiovaskulární morbidity a mortality a představuje obecný marker endoteliální dysfunkce. U pacientů s diabetes mellitus zejména 1. typu představuje mikroalbuminurie ukazatel incipientní fáze diabetické nefropatie. Progresivní kontinuálně se zvyšující vylučování albuminu do moči je všeobecně uznávaným kritériem pro kategorizaci stupně diabetického ledvinného postižení. Moderní definice diabetické nefropatie tedy zahrnuje stav zvýšeného kardiovaskulárního rizika provázeného - bez terapie - progresivním poklesem renálních funkcí a spojeného s diabetickou retinopatií. Při pozitivním nálezu mikroalbuminurie je nutno zajistit striktní kontrolu kompenzace diabetu a kontrolu systémového tlaku s cílem zamezit další progresi specifických mikrovaskulárních komplikací diabetu. V článku je uveden i přehled epidemiologických dat a současné znalosti o etiopatogenezi mikroalbuminurie u diabetické nefropatie.

Klíčová slova:
diabetes mellitus - diabetická nefropatie - mikroalbuminurie - ACE-inhibitory


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Labels
Diabetology Endocrinology Internal medicine

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