avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2015-0-5-9avk-446Research ArticleКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ ПО ЛЕЧЕНИЮ ДИАБЕТИЧЕСКОЙ НЕФРОПАТИИCLINICAL GUIDELINE FOR THE TREATMENT OF DIABETIC NEPHROPATHYНадееваР. А.NadeevaR. A.

Казань

Kazan

rosa.nadeeva@gmail.comСигитоваО. Н.SigitovaO. N.

Казань

Kazan

ГБОУ ВПО «Казанский медицинский университет»РоссияKazan State Medical UniversityRussian Federation2015281020150538Copyright © Надеева Р.А., Сигитова О.Н., 20152015Надеева Р.А., Сигитова О.Н.Nadeeva R.A., Sigitova O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/446

В связи с высокой распространенностью сахарного диабета наблюдается ежегодное увеличение количества больных с диабетической нефропатией. Прогрессирующее течение данного осложнения и высокий процент развития терминальной почечной недостаточности требует четких подходов ранней диагностики, разработки методов профилактики и своевременного лечения с позиции доказательной медицины. В данном обзоре приведены рекомендации по сахароснижающей терапии, контролю артериального давления и протеинурии, гиперлипидемии. Определены индивидуальные цели коррекции гипергликемии в зависимости от уровня экскреции альбуминурии и тяжести больного. Указаны возможности применения отдельных сахароснижающих препаратов в зависимости от уровня скорости клубочковой фильтрации. Для выбора гипотензивного лечения выделены препараты первой и второй линии. Указаны возможные способы снижения уровня альбуминурии. Даны рекомендации по ведению больных в зависимости от стадии нефропатии.

Due to the high prevalence of diabetes the annual increase of the number of patients with diabetic nephropathy is evidenced. The progressive course of this sequellae and a high percentage of end-stage kidney disease requires a clear approach of early diagnosis, the development of methods of prevention and early treatment from the perspective of evidence-based medicine. This review provides recommendations on glucose-lowering treatment, monitoring of blood pressure and proteinuria, hyperlipidemia. Defi ned individual targets of the correction of hyperglycaemia, depending on the level of albuminuria excretion and the severity of the patient. Indicated the possibilities of applications of certain antidiabetic drugs, depending on the level of glomerular fi ltration rate. Drugs of the fi rst and second line are marked for the selection of antihypertensive treatment. Showed the possible ways to reduce the level of albuminuria. Presented recommendations for the management of patients, depending on the stage of nephropathy.

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The authors declare that there are no conflicts of interest present.