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[Therapy of diabetic nephropathy]
R A Stahl1, W Schoeppe, F Thaiss
1Zentrum Innere Medizin-Abteilung Nephrologie, Johann Wolfgang Goethe-Universität, Frankfurt.
Zeitschrift Fur Kardiologie
|January 1, 1993
Summary
Strict glycemic control and early ACE-inhibitor use are key for preventing diabetic nephropathy. Manifest disease management involves metabolic control, reduced protein, and blood pressure normalization with ACE-inhibitors and calcium antagonists.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Context:
- Recent advancements in understanding diabetic nephropathy pathophysiology.
- Shift towards preventive strategies for insulin-dependent diabetic patients.
- Management of co-existing hypertension in diabetic nephropathy.
Purpose:
- To outline updated therapeutic measures for diabetic nephropathy.
- To emphasize preventive considerations and treatment of manifest disease.
- To evaluate the efficacy of antihypertensive agents on albuminuria.
Summary:
- Strict glycemic control and early angiotensin-converting enzyme (ACE) inhibitor initiation are crucial for prevention.
- Manifest diabetic nephropathy management includes metabolic control, dietary protein restriction, and achieving normotensive blood pressure.
- ACE inhibitors and calcium antagonists demonstrate effectiveness, with combination therapy potentially offering additional benefits in reducing albuminuria.
Impact:
- Significant reduction in the decline of glomerular function.
- Substantial decrease in albuminuria levels.
- Improved long-term outcomes for patients with diabetic nephropathy.