5-遵循指南安心肾选.pptVIP

二甲双胍 磺脲类 诺和龙? DPP-4抑制剂 (mL/min/1.73m2) 药物使用比例(%) 0 20 40 60 80 Del Pozo-Fernández C , et al. Nefrologia .2012;32(3):367-73 在2型糖尿病合并慢性肾脏病患者中， 诺和龙?使用比例高 * 中国专家共识推荐： 诺和龙?可用于不同肾功能的2型糖尿病患者 * 小结 在2型糖尿病合并慢性肾脏病（CKD）患者中： 诺和龙?具有丰富的临床研究资料 现有临床研究都支持诺和龙?具有理想的肾脏安全性 国内外指南（美国、瑞士和中国）一致推荐：诺和龙?可安全地用于CKD患者，无需调整剂量 * 糖尿病合并慢性肾脏病(CKD)患者比例较高，低血糖明显增加，危害较大，因此降糖治疗更需要遵循指南 指南建议：2型糖尿病合并慢性肾脏病（CKD）患者 大多数口服降糖药的肾脏安全性差，慎用或禁用 诺和龙?全面降糖，较多临床研究资料显示其具有理想的肾脏安全性，因此得到国内外指南一致推荐 总结 * Cardiorenal Med. 2011 Jan;1(1):45-52. Epub 2011 Jan 17. Diabetic Cardiovascular Disease Predicts Chronic Kidney Disease Awareness in the Kidney Early Evaluation Program. Whaley-Connell A, Bomback AS, McFarlane SI, Li S, Roberts T, Chen SC, Collins AJ, Norris K, Bakris GL, Sowers JR, McCullough PA; on behalf of the Kidney Early Evaluation Program Investigators. University of Missouri-Columbia School of Medicine, and Harry S. Truman VA Medical Center, Columbia, Mo., USA. Abstract AIMS: Lack of chronic kidney disease (CKD) awareness is common. Recent data suggest that the presence of concurrent diabetes may heighten CKD awareness, but current data have not supported the hypothesis that healthcare delivery or insurance status improves awareness in the diabetic population. Diabetes is associated with high cardiovascular disease (CVD) morbidity, especially in patients with CKD. We hypothesized that a highly prevalent co-morbid condition such as CVD in patients with diabetes would predict CKD awareness. METHODS: We utilized data from the National Kidney Foundation-Kidney Early Evaluation Program (KEEP(TM)), a large screening program designed to identify high-risk individuals for CKD and promote awareness. RESULTS: Among 77,077 participants, CKD was identified in 20,200 and diabetes in 23,082. Prevalence of CVD was higher in participants with than without diabetes (39.5 vs. 22.0%) and in stage 3-5 compared to stage 1-2 CKD (43.3 vs. 34.4%). Patients with diabetes and CVD had a higher level of awareness than those withou