Información del artículo
La nefropatía diabética es una complicación muy prevalente de la diabetes. Su abordaje exige un diagnóstico temprano, así como la reducción del impacto de los factores de riesgo implicados en su aparición y progresión: hiperglucemia, hipertensión, dislipemia y tabaquismo. Los objetivos que se deben conseguir son hemoglobina glucosilada < 7%, presión arterial < 130/80 mmHg, lipoproteínas de baja densidad < 100 mg/dl y abstinencia tabáquica. El abordaje de la hipertensión arterial exige el bloqueo del sistema renina-angiotensina, y el de la insuficiencia renal debe ser multidisciplinario y efectuarse de forma planificada, especialmente cuando se llega a la etapa terminal. En la actualidad se están estudiando diversas opciones terapéuticas, entre las que destacan la inhibición de la formación de productos avanzados de la glucosilación, el bloqueo de la proteincinasa C y el uso de glucosaminoglucanos.
Palabras clave:
Nefropatía diabética
Tratamiento
Hiperglucemia
Hipertensión
Tabaco
Diabetic nephropathy is a highly prevalent complication of diabetes, requiring early diagnosis and reduction of the impact of the risk factors involved in its pathogenesis and progression: hyperglycemia, hypertension, dyslipidemia and smoking. The targets are HbA1c < 7%, blood pressure < 130/80 mmHg, LDL-cholesterol < 100 mg/dl, and smoking cessation. Blood pressure control implies renin-angiotensin system blockade. A multidisciplinary and planned approach is mandatory in renal failure, especially in end-stage disease. Currently, several therapeutic options are being investigated, most importantly those involving inhibition of advanced glycosylated end products, protein kinase C blockade, and the use of glycosaminoglycans.
Key words:
Diabetic nephropathy
Treatment
Hyperglycemia
Hypertension
Smoking
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