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2002, Número 1-2

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Rev Hosp M Gea Glz 2002; 5 (1-2)


Nefropatía diabética

Torres VA, Zacarías CR

Idioma: Español
Referencias bibliográficas: 73
Paginas: 24-32
Archivo PDF: 108.45 Kb.


RESUMEN

La nefropatía diabética constituye una de las complicaciones más importantes de la diabetes mellitus con repercusiones definidas en la calidad de vida de los pacientes y en el pronóstico global de la enfermedad. Se conoce ahora que condiciones como el descontrol hiperglucémico crónico y la hipertensión arterial explican la patogenia del daño estructural sobre las nefronas primeramente a nivel mesangial para posteriormente tornarse en un daño más difuso que tiene una gran correlación con los estadios clínicos de Mogensen que son progresivos y que a través de los años llegan a manifestarse como insuficiencia renal terminal. El primer indicador temprano de la nefropatía diabética es la microalbuminuria y durante este estadio deben practicarse intervenciones dietéticas, control estricto de la glucemia, de la presión arterial y uso de medicamentos como los inhibidores de la enzima convertidora de angiotensina o bloqueadores de los receptores de angiotensina que han demostrado la capacidad de prevenir o retardar la progresión del daño renal en los pacientes con diabetes. Otros factores como tabaquismo, hiperlipidemia, hiperhomocistinemia e infecciones urinarias deben también evaluarse y manejarse en el tratamiento integral de la nefropatía diabética.


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