关键词: 肾疾病, 糖尿病, 治疗

Abstract:

Treatment strategy in diabetic patients with chronic kidney disease(CKD) includes lifestyle  intervention， glycemic control， blood pressurelowering therapy， lipidlowering therapy， antiplatelet therapy and renal replacement therapy. All treatments follow the principle of safety， effectiveness and individualization. Lifestyle intervention focuses at the restriction of salt and protein intake. Drug selection and dose adaptation should be based on the pharmacokinetic characteristics and the renal function.  Linagliptin， glipizide and pioglitazone can be used through the CKD process without dose adjustment.  RAAS inhibitors should be considered as an initial therapy for hypertension. Statin is recommended in diabetic patients with CKD of stage 1 to  4. Aspirin is recommended as the first choice for antiplatelet therapy and clopidogrel is an alternative for aspirin in patients with clear intolerance or contraindications for aspirin. Dialysis is initiated in patients with diabetes on the same criteria as in those without diabetes.

Key words: kidney disease, diabetes mellitus, treatments