[Therapy of diabetic nephropathy].
It appears to be confirmed by international studies that the development of end-stage nephropathy, cardiovascular mortality and morbidity can be reduced to a large extent by achieving a target blood pressure of 130/85 mmHg in diabetes hypertension and 125/75 mmHg in diabetic nephropathy. Diuretics, beta-blockers, ACE inhibitors and calcium antagonists are all recommended agents with evidence "A" according to both international and national recommendations. The most efficient nephroprotection and simultaneous intensive and efficient blood pressure reduction can be achieved by ACE inhibitors and AT1 receptor blockers as basic agents. It is often required to use combination treatment to achieve the target blood pressure. In the predialysis stage, tight blood pressure control should be completed with balanced glucose metabolism, restricted protein intake, controlled salt and water metabolism, early treatment of metabolic acidosis and preparation for kidney substitution treatment. The patient and the treating physicians should work together in a coordinated way during the complex nephrology, diabetes, cardiology care to slow down the progress of the disease.
Barna
István
I
Semmelweis Egyetem, Altalános Orvostudományi Kar, I. Sz. Belgyógyászati Klinika, Budapest.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000150:complications / Q000188:drug therapy*; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D006978:Hypertension, Renovascular / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics