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Vol. 218. Num. 6.August - September 2018
Pages 271-326
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Vol. 218. Num. 6.August - September 2018
Pages 271-326
Review
DOI: 10.1016/j.rceng.2018.03.010
Clinical assessment and treatment of diabetes in patients with chronic kidney disease
Evaluación clínica y tratamiento de la diabetes en pacientes con enfermedad renal crónica
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J. Carretero Gómez
Corresponding author
juanicarretero@gmail.com

Corresponding author.
, J.C. Arévalo Lorido
Servicio de Medicina Interna, Hospital Comarcal de Zafra, Badajoz, Spain
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Table 1. Review of the 2016 Food and Drug Administration for the use of metformin in chronic kidney disease.
Table 2. Summary of recommended antidiabetic dosages for chronic kidney disease.
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Abstract

Diabetes mellitus type 2 is the main cause of chronic kidney disease. Patients with this disease have higher morbidity and mortality and risk of hypoglycaemia than those without this disease. In 2010, type 2 diabetes was the reason for starting renal replacement therapy in 24.7% of patients. The prevalence of microalbuminuria, proteinuria and a reduced glomerular filtration rate is 36%, 8% and 22%, respectively. The presence of albuminuria is a predictor of chronic kidney disease. Diabetic kidney disease, previously known as diabetic nephropathy, refers to kidney disease caused by diabetes. Renal hyperfiltration is a marker of intraglomerular hypertension and a risk factor for onset and progression. The new antidiabetic drugs, mainly dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter inhibitors and glucagon-like peptide-1 agonists, have been shown to prevent or slow the progression of kidney disease.

Keywords:
Diabetes
Chronic kidney disease
Diabetic nephropathy
Diabetic kidney disease
SGLT2-i
GLP-1RA
DPP4-i
Resumen

La diabetes mellitus tipo2 es la principal causa de enfermedad renal crónica. Estos pacientes presentan mayor morbimortalidad y riesgo de hipoglucemias que el resto. En 2010, la diabetes tipo2 fue causa del inicio de terapia renal sustitutiva en el 24,7% de los pacientes. La prevalencia de microalbuminuria, proteinuria y disminución del filtrado glomerular es del 36, 8, y 22%, respectivamente. La presencia de albuminuria es un factor predictivo de enfermedad renal crónica. La enfermedad renal diabética, previamente conocida como nefropatía diabética, hace referencia a la enfermedad renal causada por la diabetes. La hiperfiltración renal es marcador de hipertensión intraglomerular y factor de riesgo tanto de inicio como de progresión. Los nuevos antidiabéticos, fundamentalmente los inhibidores del enzima dipeptidil peptidasa-4, los inhibidores del cotransportador de sodio/glucosa y los agonistas del péptido similar al glucagón tipo1, han demostrado prevenir o enlentecer la progresión de la enfermedad renal.

Palabras clave:
Diabetes
Enfermedad renal crónica
Nefropatía diabética
Enfermedad renal del diabético
iSGLT2
arGLP1
iDPP4

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