Patient with Type 1 Diabetes and Microalbuminuria

Yıl 2018, Cilt: 6 Sayı: 4, 20 - 25, 02.04.2018

Dr. Özlem Soyluk Selçukbiricik

Öz

Abstract

Diabetic kidney disease is one of the most common and serious chronic complications of type 1 diabetes. Microalbuminuria is one of the early findings of diabetic kidney disease and it is found to be associated with mortality. The abnormal increase of albumin excretion is due to microvascular lesions in glomerulicaused by long lasting hyperglycemia. The screening for microalbuminuria is recommended to be performed by measurement of urinary albumin to creatinineratio, after 5 years of diabetes diagnosis and repeated annually afterwards. Risk factors like long diabetes time, poor glycemic and blood pressure control, dyslipidemia and smoking increase the probability of overt diabetic kidney disease intype 1 diabetics with microalbuminuria. But the spontaneous regression of microalbuminuria to normoalbuminuria is also possible. The regulation of glycemiaand blood pressure, inhibition of renin-angiotensin-aldosterone-system and theavoidance of other risk factors are found to be effective in prevention or treatment of microalbuminuria.

Anahtar Kelimeler

Type 1 diabetes, microal-buminuria, diabetic kidney disease

Tip 1 Diyabetli ve Mikroalbuminürisi Var

Öz

Öz

Diyabetik böbrek hastalığı; tip 1 diyabetin en sık ve en ağır kronik komplikasyonlarından biridir. Mikroalbuminüri de diyabetik böbrek hastalığının erken bulgularındandır ve tip 1 diyabet hastalarında artmış mortalite ile ilişkilidir. Albumin ekskresyonundaki anormal artış, uzun süreli hipergliseminin glomerüllerde sebep olduğu mikrovasküler hasar sonucu oluşmaktadır. Mikroalbuminüri taramasının tip 1 diyabette tanıdan 5 yıl sonra yıllık olarak ve idrarda albümin-kreatinin oranı ölçümü ile yapılması önerilmektedir. Tip 1 diyabetli ve mikroalbuminürisi olan hastaların uzun dönem takibi sonucunda aşikar nefropati gelişme ihtimalinin diyabet süresi ve kötü glisemik kontrol, dislipidemi, sigara, hipertansiyon gibi diğer risk faktörleri ile ilişkili olduğu gösterilmiştir. Ancak mikroalbuminürinin normoalbuminüriye spontan regresyonu da mümkündür. Mikroalbüminüriden korunmada veya normoalbuminüriye regresyonun sağlanmasında glisemi ve kan basıncı kontrolünün, renin-anjiyotensin-aldosteron-sisteminin inhibe edilmesinin ve diğer risk faktörlerinin bertaraf edilmesinin etkili olduğu gösterilmiştir.

Anahtar Kelimeler

Tip 1 diyabet, mikroalbu-minüri, diyabetik böbrekhastalığı

Kaynakça

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