解剖学と生理学: 現在の研究
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概要

Nutritional Approach to Diabetic Nephropathy

Anita Saxena

Diabetes is an important cause of renal disease. Diabetic nephropathy (DN) is characterized by albuminuria, which is usually accompanied by hypertension, progressive rise in proteinuria (albuminuria >0.5 g/24 h), and decline in renal function. Long term complications of diabetes are macrovascular disease (coronary heart disease), cerebrovascular disease, peripheral arterial disease and microvascular disease retinopathy and nephropathy. DN carries a 20- to 40-fold increased risk for cardiovascular (CV) mortality. To delay progression of DN to ESRD following measures are recommended a) good control of blood glucose, b) low-protein diet, c) control of hypertension, d) restriction of dietary salt, phosphorus and potassium in advanced cases and e) control of hyperfiltration, usually through angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blocking (ARB) agents. ACE inhibitors reduce proteinuria and glomerulosclerosis. Mangement of proteinuria with diet has shown that antiproteinuric effect is strongly dependent on dietary sodium restriction.