The Main Approaches in the Treatment of Chronic Kidney Disease Based on International Recommendations
Keywords:
Nephropathy, glomerular filtration rate, diabetes mellitus, hyperglycemiaAbstract
Diabetic nephropathy (DN) is a serious health problem. It occurs in 50% of people living with diabetes, is the main cause of terminal stage kidney disease (TSKD) requiring treatment with dialysis or kidney transplantation, and is associated with a significant increase in cardiovascular morbidity and mortality. DN is a clinical syndrome characterized by persistent albuminuria and progressive decrease in kidney function, but it is increasingly recognized that the manifestations and clinical course of kidney disease in diabetes are heterogeneous. The term "diabetic kidney disease" (DBP) is currently widely used to refer to people with diabetes who have either albuminuria or decreased kidney function. This article will discuss the clinical picture and approach to the diagnosis of DBP, as well as its prognosis. The general principles of DKD management will also be reviewed with reference to the current international recommendations.
References
Badridinova B.K. [Risk factors for diabetic nephropathy in patients with type 1 diabetes mellitus]. 2020, vol. 1, no. 3, pp. 41-45.
Хkhattabov M.Kh., Badridnova B.K. Influence Of Covid-19 On The Course Of Chronic Renal Failure. – 2023.
Badridinova B.K. Treatment of iron deficiency anemia in chronic kidney disease and end-stage renal failure //New day in medicine-Bukhara. - 2022. - No. 9. - p. 47.
Badridinova B.K. Comparative Analysis Of Program Hemodialysis Efficiency And Impact On Quality Of Life //Uzbek Scholar Journal. – 2022. – Т. 11. – С. 186-192.
Ismoilova Sh.S. TREATMENT OF CHRONIC KIDNEY DISEASE IN TYPE 2 DIABETES MELLITUS: GOALS OF SCREENING, DIAGNOSTICS AND TREATMENT, AS WELL AS RECOMMENDATIONS / / AMALIY VA TIBBIYOT FANLARI ILMIY JURNALI. - 2024. - VOL. 3. - NO. 3. - PP. 211-215.
Nazarova A. B. MONITORING THE POSITIVE EFFECT OF GLOW-LOWING DRUGS ON THE KIDNEYS IN PATIENTS WITH TYPE II DIABETES MELLITUS //FAN, TA'LIM, MADANIYAT VA INNOVATSIYA JURNALI| JOURNAL OF SCIENCE, EDUCATION, CULTURE AND INNOVATION. – 2024. – Т. 3. – №. 4. – С. 247-249.
Parving HH, Hommel E, Mathiesen E, et al. Prevalence of microalbuminuria, arterial hypertension, retinopathy and neuropathy in patients with insulin dependent diabetes. Br Med J (Clin Res Ed). 1988; 296(6616): 156-160.
Rossing P, Hougaard P, Parving HH. Progression of microalbuminuria in type 1 diabetes: ten-year prospective observational study. Kidney Int. 2005; 68(4): 1446-1450.
Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019; 157: 107843.
Parving HH, Lewis JB, Ravid M, Remuzzi G, Hunsicker LG, DEMAND. Investigators. Prevalence and risk factors for microalbuminuria in a referred cohort of type II diabetic patients: a global perspective. Kidney Int. 2006; 69(11): 2057-2063.
See E, Jayasinghe K, Glassford N, et al. Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure. Kidney Int. 2019; 95: 160-172.
Yu SM, Bonventre JV. Acute kidney injury and progression of diabetic kidney disease. Adv Chronic Kidney Dis. 2018; 25(2): 166-180.
Jiang S, Wang Y, Zhang Z, Dai P, Yang Y, Li W. Accuracy of hematuria for predicting non-diabetic renal disease in patients with diabetes and kidney disease: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2018; 143: 288-300.
Leung N, Bridoux F, Batuman V, et al. The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group. Nat Rev Nephrol. 2019; 15(1): 45-59.
Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an ADA consensus conference. Diabetes Care. 2014; 37(10): 2864-2883.
Gaspari F, Ruggenenti P, Porrini E, et al. The GFR and GFR decline cannot be accurately estimated in type 2 diabetics. Kidney Int. 2013; 84(1): 164-173.
Luis-Lima S, Porrini E. An overview of errors and flaws of estimated GFR versus true GFR in patients with diabetes mellitus. Nephron. 2017; 136(4): 287-291.
Raman M, Middleton RJ, Kalra PA, Green D. Estimating renal function in old people: an in-depth review. Int Urol Nephrol. 2017; 49(11): 1979-1988.
Miller WG, Bruns DE, Hortin GL, et al. Current issues in measurement and reporting of urinary albumin excretion. Clin Chem. 2009; 55(1): 24-38.
Andersen AR, Christiansen JS, Andersen JK, Kreiner S, Deckert T. Diabetic nephropathy in type 1 (insulin-dependent) diabetes: an epidemiological study. Diabetologia. 1983; 25(6): 496-501.
Adler AI, Stevens RJ, Manley SE, et al. Development and progression of nephropathy in type 2 diabetes: the United Kingdom prospective diabetes study (UKPDS 64). Kidney Int. 2003; 63(1): 225-232.
de Boer IH, Sun W, Cleary PA, et al. Longitudinal changes in estimated and measured GFR in type 1 diabetes. J Am Soc Nephrol. 2014; 25(4): 810-818.
de Boer IH, Afkarian M, Rue TC, et al. Renal outcomes in patients with type 1 diabetes and macroalbuminuria. J Am Soc Nephrol. 2014; 25(10): 2342-2350.
Skupien J, Smiles AM, Valo E, et al. Variations in risk of end-stage renal disease and risk of mortality in an international study of patients with type 1 diabetes and advanced nephropathy. Diabetes Care. 2019; 42(1): 93-101.
Rossing K, Christensen PK, Hovind P, Tarnow L, Rossing P, Parving HH. Progression of nephropathy in type 2 diabetic patients. Kidney Int. 2004; 66(4): 1596-1605.
Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001; 345(12): 851-860.
Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001; 345(12): 861-869.
Amin AP, Whaley-Connell AT, Li S, et al. The synergistic relationship between estimated GFR and microalbuminuria in predicting long-term progression to ESRD or death in patients with diabetes: results from the kidney early evaluation program (KEEP). Am J Kidney Dis. 2013; 61(4 Suppl 2): S12-S23.
Radcliffe NJ, Seah JM, Clarke M, MacIsaac RJ, Jerums G, Ekinci EI. Clinical predictive factors in diabetic kidney disease progression. J Diabetes Investig. 2017; 8(1): 6-18.
Tangri N, Stevens LA, Griffith J, et al. A predictive model for progression of chronic kidney disease to kidney failure. JAMA. 2011; 305(15): 1553-1559.
National Institute for Health and Care Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modifification. Clinical guideline [CG181]. 2014. nice.org.uk/guidance/cg181.
National Institute for Health and Care Excellence. Hypertension in adults: diagnosis and management. NICE guideline [NG136]. 2019. www.nice.org.uk/guidance/ng136.
Gaede P, Vedel P, Parving HH, Pedersen O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: the steno type 2 randomised study. Lancet. 1999; 353(9153): 617-622.
Oellgaard J, Gaede P, Rossing P, Persson F, Parving HH, Pedersen O. Intensified multifactorial intervention in type 2 diabetics with microalbuminuria leads to long-term renal benefits. Kidney Int. 2017; 91(4): 982-988.
Diabetes Control Complications Trial Research Group, Nathan DM, Genuth S, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993; 329(14): 977-986.
Diabetes Control Complications Trial/Epidemiology of Diabetes Interventions Complications Research Group. Sustained effect of intensive treatment of type 1 diabetes mellitus on development and progression of diabetic nephropathy: the epidemiology of diabetes interventions and complications (EDIC) study. JAMA. 2003; 290(16): 2159-2167.