2型糖尿病肾病-从病理机制到临床职业医学实践

M. Oțelea, Daniel Dragu
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摘要

患有糖尿病和肾病的员工需要职业医学专家的特殊医疗监测。然而,糖尿病并不是一种独特的表型,每个患者都需要仔细评估。年龄、性别、体重指数、肾功能损害(eGFR、肌酐、尿素、尿酸)、糖尿病控制指标(空腹血糖和糖化血红蛋白)、是否存在合并症、血脂异常、血清白蛋白和总蛋白水平、细胞因子和其他炎症标志物,应综合评价慢性肾病的严重程度和治疗方案。2型糖尿病的慢性肾脏疾病有许多方面和不同程度的严重程度;因此,职业医学专科医生和治疗医师之间应该保持长期的沟通。为此,本文综述了目前提出的慢性肾脏疾病的病理机制、诊断和一般治疗建议以及2型糖尿病肾病患者可能的职业干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diabetic nephropathy in type 2 diabetes – from pathological mechanisms to clinical occupational medicine practice
Abstract Employees with diabetes and nephropathy need special medical surveillance that involves occupational medicine specialists. However, diabetes is not a unique phenotype and each patient need to be carefully assessed. Age, gender, body mass index, renal function impairment (eGFR, creatinine, urea, uric acid), indicators of diabetes control (fasting glycaemia and HbA1C), the presence of co-morbidities, dyslipidaemia, level of serum albumin and total protein, cytokines and other inflammatory markers should be considered in a comprehensive evaluation of the severity of the chronic kidney disease and of the treatment plan. Chronic kidney disease in type 2 diabetes has many facets and various degrees of severity; therefore, permanent communication between the occupational medicine specialist and the treating physician should be maintained. For this purpose, this article reviews the current pathological mechanisms proposed for the explanation of the chronic kidney disease, the diagnostic and the general therapeutic recommendations and also the possible occupational interventions in patients with type 2 diabetic nephropathy.
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