2017美国糖尿病指南英文版9.pdfVIP

S72 Diabetes Care Volume 39, Supplement 1, January 2016 9. Microvascular Complications American Diabetes Association and Foot Care Diabetes Care 2016;39(Suppl. 1):S72–S80 | DOI: 10.2337/dc16-S012 DIABETIC KIDNEY DISEASE Recommendations Screening c At least once a year, assess urinary albumin (e.g., spot urinary albumin–to– creatinine ratio) and estimated glomerular filtration rate in patients with E type 1 diabetes with duration of $5 years, in all patients with type 2 diabetes, R A and in all patients with comorbid hypertension. B C T O Treatment O F c Optimize glucose control to reduce the risk or slow the progression of diabetic D N kidney disease. A A S c Optimize blood pressure control (,140/90 mmHg) to reduce the risk or slow N O I the progression of diabetic kidney disease. A T A c For people with nondialysis-dependent diabetic kidney disease, dietary pro- C I L P tein intake should be 0.8 g/kg body weight per day (the recommended daily M O allowance). For patients on dialysis, higher levels of dietary protein intake C R should be considered. A A L c Either an ACE inhibitor or an angiotensin receptor blocker is recommended for U C S the treatment of nonpregnant patients with diabetes and modestly elevated A V urinary albumin excretion (30–299 mg/day) B and is strongly recommended O R C for those with urinary albumin excretion $300 mg/day and/or estimated I M