J Am Soc Nephrol：白蛋白尿而非GFR的变化与2型糖尿病患者肾脏结构的早期变化有关

2020-06-16 MedSci原创 MedSci原创

在1型糖尿病中，GFR和尿液白蛋白与肌酐比值(ACR)的变化与反映疾病进展的肾脏结构变化有关。然而，这种变化尚未在2型糖尿病中进行研究。

在1型糖尿病中，GFR和尿液白蛋白与肌酐比值(ACR)的变化与反映疾病进展的肾脏结构变化有关。然而，这种变化尚未在2型糖尿病中进行研究。

参与者为2型糖尿病的美国印第安人，他们参加了洛沙坦与安慰剂的临床试验。我们跟踪了一个在6年试验结束时接受肾活检的子集，每年测量GFR（通过尿液清除碘酒）和ACR。参与者在平均随访9.3年后进行了第二次肾脏活检。我们使用定量形态分析来评估两个活检标本。

最终48名参与者（12名男性和36名女性，平均年龄45.6岁）完成研究，基线测量包括糖尿病持续时间（14.6年）、GFR（156ml/min）和ACR（15mg/g）。随访期间，肾小球基底膜（GBM）宽度、间质分量和ACR增加，外周GBM表面密度和GFR下降。校正性别、年龄、ACR和基线时的各形态学变量后，随访期间ACR的增加与GBM宽度、间质分量和平均肾小球体积的增加以及外周GBM表面密度的下降显著相关。在另外校正基线GFR后，GFR的下降与这些形态学变量的变化无关。

总之，在患有2型糖尿病且基线GFR保留的美国印第安人中，ACR的增加反映了早期结构性肾小球病变的进展，而早期GFR下降可能不能准确反映这种病变。

原始出处：

Helen C Looker, Michael Mauer, et al., Changes in Albuminuria But Not GFR Are Associated With Early Changes in Kidney Structure in Type 2 Diabetes. J Am Soc Nephrol. 2019 Jun;30(6):1049-1059. doi: 10.1681/ASN.2018111166.

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2020-06-18 珙桐

#白蛋白#

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2020-06-18 apoenzyme

#白蛋白尿#

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2020-06-18 aids213

#2型糖尿病患者#

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2020-06-18 xue8604

#糖尿病患者#

34 0
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2020-06-18 医者仁心

#GFR#

31 0
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2020-06-16 misszhang

谢谢MedSci提供最新的资讯

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J Am Soc Nephrol：白蛋白尿而非GFR的变化与2型糖尿病患者肾脏结构的早期变化有关

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