PDF(Pubmed)
Abstract：
Chronic kidney disease (CKD) is a growing global public health challenge worldwide. In Mexico, CKD prevalence is alarmingly high and remains a leading cause of morbidity and mortality. Diabetic kidney disease (DKD), a severe complication of diabetes, is a leading determinant of CKD. The escalating diabetes prevalence and the complex regional landscape in Mexico underscore the pressing need for tailored strategies to reduce the burden of CKD. This narrative review, endorsed by the Mexican College of Nephrologists, aims to provide a brief overview and specific strategies for healthcare providers regarding preventing, screening, and treating CKD in patients living with diabetes in all care settings. The key topics covered in this review include the main cardiometabolic contributors of DKD (overweight/obesity, hyperglycemia, arterial hypertension, and dyslipidemia), the identification of kidney-related damage markers, and the benefit of novel pharmacological approaches based on Sodium-Glucose Co-Transporter-2 Inhibitors (SGLT2i) and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RA). We also address the potential use of novel therapies based on Mineralocorticoid Receptor Antagonists (MRAs) and their future implications. Emphasizing the importance of multidisciplinary treatment, this narrative review aims to promote strategies that may be useful to alleviate the burden of DKD and its associated complications. It underscores the critical role of healthcare providers and advocates for collaborative efforts to enhance the quality of life for millions of patients affected by DKD.
摘要：
慢性肾脏病（CKD）是全球范围内日益严重的全球公共卫生挑战。在墨西哥,CKD患病率高得惊人，仍然是发病率和死亡率的主要原因。糖尿病肾病（DKD），糖尿病的严重并发症，是CKD的主要决定因素。墨西哥不断升级的糖尿病患病率和复杂的区域景观强调了迫切需要量身定制的策略来减轻CKD的负担。这篇叙述性评论，由墨西哥肾脏病学家学院认可，旨在为医疗保健提供者提供关于预防，筛选,并在所有护理环境中治疗糖尿病患者的CKD。本综述涵盖的关键主题包括DKD的主要心脏代谢贡献者（超重/肥胖，高血糖症,动脉高血压,和血脂异常)，肾脏相关损伤标志物的鉴定，以及基于钠-葡萄糖共转运蛋白-2抑制剂（SGLT2i）和胰高血糖素样肽-1受体激动剂（GLP-1RA）的新型药理学方法的益处。我们还讨论了基于盐皮质激素受体拮抗剂（MRA）的新疗法的潜在用途及其未来意义。强调多学科治疗的重要性，这篇叙述性综述旨在推广可能有助于减轻DKD及其相关并发症负担的策略.它强调了医疗保健提供者的关键作用，并倡导共同努力，以提高数百万受DKD影响的患者的生活质量。
