Item type |
学術雑誌論文 / Journal Article(1) |
公開日 |
2010-08-10 |
タイトル |
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タイトル |
糖尿病性腎症の診断と治療(シリーズ「糖尿病の治療」(6)) |
言語 |
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言語 |
jpn |
資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
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資源タイプ |
journal article |
別タイトル |
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その他のタイトル |
Diagnosis and Treatments of Diabetic Nephropathy(Series "Treatment of Diabetes Mellitus" (6)) |
著者名 |
馬場園, 哲也
林, 俊秀
大田, 真理
坊内, 良太郎
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著者別名 |
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姓名 |
BABAZONO, Tetsuya |
著者別名 |
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姓名 |
HAYASHI, Toshihide |
著者別名 |
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姓名 |
OTA, Mari |
著者別名 |
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姓名 |
BOUUCHI, Ryotaro |
出版者 |
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出版者 |
東京女子医科大学学会 |
受付日付 |
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日付 |
2010-08-10 |
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日付タイプ |
Created |
ISSN |
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収録物識別子タイプ |
ISSN |
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収録物識別子 |
0040-9022 |
NCID |
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収録物識別子タイプ |
NCID |
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収録物識別子 |
AN00161368 |
書誌情報 |
東京女子医科大学雑誌
巻 75,
号 10/11,
p. 405-410,
発行日 2005-11
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著者版フラグ |
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出版タイプ |
VoR |
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出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
抄録 |
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内容記述タイプ |
Abstract |
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内容記述 |
Diabetic nephropathy has been the leading cause of end-stage renal disease in Japan since 1998. Mortality rates after commencing dialysis are higher in diabetic patients than in non-diabetic patients; therefore, early diagnosis and treatment of this serious complication are issues of prime importance. Diabetic nephropathy is classified into the following 5 stages; stage 1: normoalbuminuria, stage 2: microalbuminuria, stage 3: clinical albuminuria, stage 4: renal failure, and stage 5: dialysis stage. For quantitative evaluation of albuminuria in diabetic patients, measurement of albumin excretion in a 24-h urine collection has been the gold standard; however, collection errors due to improper timing and missed samples may lead to significant over- and under-estimation of albuminuria. For convenience and consistency, recent guidelines recommended measurement of albumin-to-creatinine ratio (ACR) in a random spot urine collection. Normoalbuminuria is diagnosed if ACR < 30 mg/g creatinine, microalbuminuria if ACR was 30-299 mg/g creatinine, and clinical albuminuria if ACR ⪰ 300 mg/g creatinine. Evidence indicates strict glycemic control and tightly lowering blood pressure are both effective to prevent the onset and progression of nephropathy. Hemoglobin Aic, as a measure of glycemic control, is recommended to maintain<6.5%. Recent guidelines proposed lower values of blood pressure (130/80 mmHg) for diabetic patients than for non-diabetic patients (140/90 mmHg). Regarding the selection of antihypertensive drugs, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are recommended as the first line therapy for hypertension in diabetes. Most of diabetic patients, especially those with advanced nephropathy, require more than two antihypertensive drugs to establish target levels of blood pressure; therefore, adding calcium-channel blockers, beta-adrenergic blockers, and small dose of diuretics should be considered as appropriate according to each patient's condition. |
著者所属 |
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東京女子医科大学糖尿病センター |
著者所属 |
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東京女子医科大学糖尿病センター |
著者所属 |
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東京女子医科大学糖尿病センター |
著者所属 |
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東京女子医科大学糖尿病センター |
著者キーワード |
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主題Scheme |
Other |
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主題 |
diabetic nephropathy |
著者キーワード |
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主題Scheme |
Other |
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主題 |
albuminuria |
著者キーワード |
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主題Scheme |
Other |
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主題 |
hypertension |