糖尿病肾脏疾病早期预测与诊断专家共识.pdfVIP

糖尿病肾脏疾病早期预测与诊断专家共识 1 2 3 1 张俊清 苏白海 张捷 郭晓蕙 代表糖尿病肾脏疾病早期预测与诊断专家共识组 1 2 3 北京大学第一医院内分泌科100034；四川大学华西医院肾内科，成都610041；北京大 学第三医院检验科100083 张俊清、苏白海及张婕对本文有同等贡献 通信作者：郭晓蕙，Email：bdyyguoxiaohui@ 【提要】 糖尿病肾脏疾病（DKD）是指由糖尿病所致的慢性肾脏疾病（CKD），通常是根据尿白蛋 白升高和/或估算的肾小球滤过率下降，同时排除其他CKD而做出的临床诊断。DKD的临床特征为 逐渐进展的蛋白尿、渐进性肾功能下降，晚期出现严重肾衰竭，是糖尿病患者的主要死亡原因之一。 单一的筛查指标判断肾脏是否存在损伤可能存在一些缺陷，因此临床医生应结合多种辅助检查方法 来综合判断。同时应该增强对糖尿病患者肾脏损伤的重视程度，规范对糖尿病患者肾脏损伤的评估， 加强DKD的早期预测与诊断。 【关键词】 糖尿病肾病； 早期诊断； 肾脏损伤评估 基金项目 ：“十三五”国家重点研发计划项目（2016YFC1305400）；北京市科技计划项目 （D171100002817001） Expert consensus on early prediction and diagnosis of diabetic kidney disease Zhang Junqing1 2 3 1 , Su Baihai , Zhang Jie , Guo Xiaohui , on behalf of Expert Consensus Group for Early Prediction and Diagnosis of Diabetic Kidney Disease 1Department of Endocrinology, Peking University First Hospital, Beijing 100034, China; 2Department of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China; 3Department of Laboratory Medicine, Peking University Third Hospital, Beijing 100083, China Zhang Junqing, Su Baihai and Zhang Jie are contributed equally to this article Corresponding author: Guo Xiaohui, Email: bdyyguoxiaohui@ 【Summary】 Diabetic kidney disease (DKD) is a type of chronic kidney disease (CKD) caused by diabetes. The clinical diagnosis of DKD is usually based on the presence of increased albuminuria and/or decreased estimated glomerular filtration rate (eGFR), and exclusion of other causes of CKD. The clinical features of DKD are proteinuria, gradual decline in renal function, and severe renal failure in the later stages, which is one of the main causes of death in patients with diabetes. Any single biomarker might be insufficient to evaluate renal inju