本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M24-0764

摘要内容如下：

近15%的美国成年人患有糖尿病；2型糖尿病（T2D）占病例的90%以上。大约三分之一的糖尿病患者会发展为慢性肾脏疾病（CKD）。所有T2D患者应每年进行CKD筛查，包括尿白蛋白-肌酐比值和估计的肾小球滤过率。在T2D和CKD患者中，减缓CKD恶化并降低肾脏和心血管发病率的策略研究已取得实质性进展。2022年，美国糖尿病协会和肾脏疾病：改善全球结果的共识声明建议优先使用钠-葡萄糖协同转运蛋白-2抑制剂和二甲双胍，并包括对大多数一线治疗失败的患者使用胰高血糖素样肽1受体激动剂的附加治疗的指导。它还推荐非甾体类盐皮质激素受体拮抗剂用于血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂不能充分控制的高血压患者。在这里，一位内分泌学家和一位肾病学家讨论了T2D和CKD患者的护理，以及他们如何将共识声明应用于不知道自己患有CKD的T2D患者的护理。

英文原文如下：

Abstracts

Nearly 15% of U.S. adults have diabetes; type 2 diabetes (T2D) accounts for more than 90% of cases. Approximately one third of all patients with diabetes will develop chronic kidney disease (CKD). All patients with T2D should be screened annually for CKD with both a urine albumin-creatinine ratio and an estimated glomerular filtration rate. Research into strategies to slow the worsening of CKD and reduce renal and cardiovascular morbidity in patients with T2D and CKD has evolved substantially. In 2022, a consensus statement from the American Diabetes Association and the Kidney Disease: Improving Global Outcomes recommended prioritizing the use of sodium-glucose cotransporter-2 inhibitors and metformin and included guidance for add-on therapy with glucagon-like peptide 1 receptors agonists for most patients whose first-line therapy failed. It also recommended nonsteroidal mineralocorticoid receptor antagonists for patients with hypertension that is not adequately controlled with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. Here, an endocrinologist and a nephrologist discuss the care of patients with T2D and CKD and how they would apply the consensus statement to the care of an individual patient with T2D who is unaware that he has CKD.

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