科研之友
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摘要
The year 2012 was a key year for diabetic nephropathy. First data from the German chronic kidney disease-study (GCKD) as a register of the course of nephropathy with CKD stages 2-5 were published. According to this study hypertensive nephropathy has replaced diabetic nephropathy as the main reason for initiating chronic hemodialysis treatment. Genetic studies for unraveling the genetic background became rarer and the focus was on hypothesis-free genome-wide association studies. The study results indicated how critical the definition of the phenotype including the controls is to be seen in the face of the disillusioning results. Just as always no biological effects were demonstrated. Urinary podocalyxin could become a marker for the early impairment of podocytes in diabetic patients. Furthermore, the premature termination of the "aliskirin trial in type 2 diabetes using cardiovascular and renal disease endpoints" (ALTITUDE) trial which tested the dual blockade of the renin-angiotensin-aldosterone (RAAS) system and aliskirin plus angiotensin conversion enzyme (ACE) inhibitor or sartan, has been relined by published data. The initial increase of strokes could not be confirmed; however, there were significantly more episodes of hyperkalemia, which can be attributed to serious flaws in the study design.
- 出版日期2013-7
