Treatment of diabetic nephropathy
出自KMU Wiki
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差異)
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- HbA1C goal (6.5-7%, 8% if aged or ≥ stage 3 CKD)
- Risk of hypoglycemia in RF (renal failure)
- ACEI/ARB/DRI (if not pregnant) (do not combine)
- For H/T, microalbuminuria/proteinuria/eGFR<60
- Efferent arteriole dilation → transiently ↓ GFR
- Watch for hyperkalemia, AKI
- BP:
- Type 1 DM: ACEI, (ARB) or direct renin inhibitor (DRI)
- Type 2 DM: ACEI, ARB or DRI
- Plus: calcium channel blockers, diuretics, etc.
- Low protein diet (0.8 g/kg/day)
- In advanced CKD (≥ stage 4): “renal failure diet” (high calories, low protein, low salt, low K)
