Журнал «» Том 17, №2, 2024
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Альбумін-креатинінове співвідношення у сечі: діагностичне та прогностичне значення щодо уражень нирок за умов артеріальної гіпертензії та цукрового діабету 2-го типу (огляд літератури)
Авторы: Милославський Д.К., Коваль С.М., Щенявська О.М.
ДУ «Національний інститут терапії імені Л.Т. Малої НАМН України», м. Харків, Україна
Рубрики: Кардиология
Разделы: Справочник специалиста
Версия для печати
Резюме
В огляді вітчизняних та закордонних джерел літератури з наукометричної бази PubMed та сучасних європейських керівництв розглядаються аспекти використання чутливого лабораторного маркера альбумін-креатинінового співвідношення у сечі (АКСС), його діагностичного та прогностичного значення щодо уражень нирок серед хворих групи дуже високого ризику, а саме за умов поєднаного перебігу артеріальної гіпертензії та цукрового діабету 2-го типу. Авторами наводяться дані щодо визначення альбумінурії в історичному аспекті, класифікації її проявів, показань до визначення, розглядається питання щодо інформативності та специфічності цього показника як раннього чинника виникнення гіпертрофії лівого шлуночка, серцевої недостатності, діабетичної нефропатії, ожиріння, ліпідних порушень, показника глікемічного контролю, прогнозування серцево-судинних і ниркових наслідків, смертності від цих захворювань. Розглядається питання щодо більшої значущості АКСС порівняно з розрахунковою швидкістю клубочкової фільтрації щодо прогнозування виникнення переддіабету та цукрового діабету, діабетичної ретинопатії. Наводяться дані щодо поширеності, захворюваності та смертності від ниркових ускладнень артеріальної гіпертензії і цукрового діабету 2-го типу, надається стисла характеристика терапевтичних підходів щодо їх корекції.
The review of domestic and foreign sources of literature from the PubMed database and modern European guidelines examines aspects of using a sensitive laboratory marker, the urine albumin-creatinine ratio, its diagnostic and prognostic value in terms of kidney damage among very high-risk patients, namely in those with a comorbidity of hypertension and type 2 diabetes. The authors provide data on the definition of albuminuria in a historical aspect, classification of its manifestations, indications for determination, consider the question of the informativity and specificity of this parameter as an early factor in the occurrence of left ventricular hypertrophy, heart failure, diabetic nephropathy, obesity, lipid disorders, indicator of glycemic control, prognosis of cardiovascular and renal consequences, mortality from these diseases. The issue of greater significance of albumin-creatinine ratio compared to the estimated glomerular filtration rate in predicting the occurrence of pre-diabetes and diabetes mellitus, diabetic retinopathy is considered. Data are provided on the prevalence, morbidity and mortality from renal complications of hypertension and type 2 diabetes, and a brief description of therapeutic approaches to their correction is given.
Ключевые слова
артеріальна гіпертензія; цукровий діабет 2-го типу; альбумін-креатинінове співвідношення у сечі; серцево-судинні та ниркові ускладнення; огляд
hypertension; type 2 diabetes; urine albumin-creatinine ratio; cardiovascular and renal complications; review
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