PDF(Pubmed)
Abstract：
Diabetic nephropathy (DN) represents a significant microvascular complication in diabetes, entailing intricate molecular pathways and mechanisms associated with cardiorenal vascular diseases. Prolonged hyperglycemia induces renal endothelial dysfunction and damage via metabolic abnormalities, inflammation, and oxidative stress, thereby compromising hemodynamics. Concurrently, fibrotic and sclerotic alterations exacerbate glomerular and tubular injuries. At a macro level, reciprocal communication between the renal microvasculature and systemic circulation establishes a pernicious cycle propelling disease progression. The current management approach emphasizes rigorous control of glycemic levels and blood pressure, with renin-angiotensin system blockade conferring renoprotection. Novel antidiabetic agents exhibit renoprotective effects, potentially mediated through endothelial modulation. Nonetheless, emerging therapies present novel avenues for enhancing patient outcomes and alleviating the disease burden. A precision-based approach, coupled with a comprehensive strategy addressing global vascular risk, will be pivotal in mitigating the cardiorenal burden associated with diabetes.
摘要：
糖尿病肾病(DN)是糖尿病中一种显著的微血管并发症,与心肾血管疾病相关的复杂分子途径和机制。长期高血糖通过代谢异常诱导肾内皮功能障碍和损伤，炎症,和氧化应激，从而损害血液动力学。同时,纤维化和硬化改变加剧肾小球和肾小管损伤。在宏观层面，肾微脉管系统和体循环之间的相互交流建立了推动疾病进展的恶性循环。目前的管理方法强调严格控制血糖水平和血压,与肾素-血管紧张素系统阻断赋予肾脏保护。新型抗糖尿病药物表现出肾脏保护作用，可能通过内皮调制介导。尽管如此，新兴疗法为提高患者预后和减轻疾病负担提供了新的途径.基于精度的方法，加上解决全球血管风险的全面战略，将是减轻与糖尿病相关的心肾负担的关键。
