[Therapy of diabetic nephropathy].
New pathophysiological insights in the last few years on the development of diabetic nephropathy have led to a change in therapeutic measures. The emphasis is put on preventive considerations for the insulin-dependent diabetic patient. Strict control of glycemia and the early use of an angiotensin-conversion inhibitor are of importance. Therapy of the manifest diabetic nephropathy is based on strict metabolic control combined with reduced protein intake. Furthermore, an often co-existing hypertension needs to be treated. Normotensive blood pressure should be obtained. ACE-inhibitors and Ca-antagonists have been proven to be very effective, although there seem to exist differences in the type of Ca-antagonists regarding effectiveness on albuminuria. The combination of ACE-inhibitors and Ca-antagonists seems to have an additional beneficial impact on albuminuria. A significant decrease in the loss of glomerular function and a decrease in albuminuria can be obtained by consistent consideration of these therapeutic strategies.
Stahl
R A
RA
Zentrum Innere Medizin-Abteilung Nephrologie, Johann Wolfgang Goethe-Universität, Frankfurt.
Schoeppe
W
W
Thaiss
F
F
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000503:physiopathology; D004044:Dietary Proteins / Q000008:administration & dosage; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy* / Q000503:physiopathology
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004044:Dietary Proteins
Therapie der diabetischen Nephropathie.