1型糖尿病患者の末期腎疾患の発生率

Patrik Finne¹, Antti Reunanen, Svante Stenman

¹Finnish Registry for Kidney Diseases, Helsinki, Finland. patrik.finne@hus.fi

JAMA

|October 13, 2005

まとめ

1型糖尿病における末期腎疾患 (ESRD) のリスクは,時間の経過とともに減少しています. 5歳未満の早期診断は,ESRDを避けるための最良の予後を示します.

科学分野:

ネフロロジーはネフロロジーを用います.
エンドクリノロジーエンドクリノロジー
エピデミオロジーエピデミオロジー

背景:

末期腎疾患 (ESRD) は1型糖尿病の重症合併症ですが,リスクデータは限られています.
長期的なESRDリスクを理解することは,1型糖尿病の管理に不可欠です.

研究の目的:

1型糖尿病でESRDを発症する長期的なリスクを推定する.
診断時の年齢,診断期間,性別がESRDリスクに与える影響を分析する.

主な方法:

30歳未満で1型糖尿病と診断された20005人のフィンランドのコホート (1965年-1999年) が研究されました.
フォローアップは,診断からESRD,死亡,または2001年12月31日まで,競合するリスク分析が行われました.

主要な成果:

累積的なESRD発生率は,20歳では2.2%で,30歳では7.8%でした.
より低いリスクは,より若い年齢 (<5歳) での診断および後の診断期間の診断で観察されました.
ESRDのリスクにおける性別による有意な差は見つかりませんでした.

結論:

ESRDに関する1型糖尿病の予後は,40年以上にわたって改善されています.
5歳以前に診断された子供は,最も好ましいESRDの予後をします.
全体的にESRDの発生率は,以前に推定されたより低い可能性があります.

さらに関連する動画

06:27

Accelerated Type 1 Diabetes Induction in Mice by Adoptive Transfer of Diabetogenic CD4+ T Cells

Published on: May 6, 2013

05:18

A Protocol for Constructing a Rat Wound Model of Type 1 Diabetes

Published on: February 17, 2023

関連する概念動画

01:36

Carbohydrate Metabolism

Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...

01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...

01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...

01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...

01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.

01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...

関連する実験動画