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1、InteractionbetweenRenalMedullaryPGE2and(P)RRinDiabeticNephropathyandHypertensionTianxinYang1,2andWeidongWang11InstituteofHypertension,SunYat-senUniversitySchoolofMedicine;2DepartmentofInternalMedicine,UniversityofUtahPrevalenceofCKDCDC2010IncidentRateofESRDNID
2、DK2010ESRDCostsNIDDK2010DiabetesHypertensionGlomerulonephritisPKDKidneystonesDrugsRASProteinuriaPodocytedamageDiabetesMellitusandDiabeticNephropathyNearly26millionAmericanshavediabetes,accordingtonewestimatesfromtheCentersforDiseaseControlandPrevention(CDC).In
3、addition,anestimated79millionU.S.adultshaveprediabetes,aconditioninwhichbloodsugarlevelsarehigherthannormal,butnothighenoughtobediagnosedasdiabetes.Prediabetesraisesaperson'sriskoftype2diabetes,heartdiseaseandstroke.Diabetesaffects8.3percentofAmericansofallage
4、s,and11.3percentofadultsaged20andolder,accordingtotheNationalDiabetesFactSheetfor2011.About27percentofthosewithdiabetes—7millionAmericans—donotknowtheyhavethedisease.Prediabetesaffects35percentofadultsaged20andolder.NationalDiabetesFactSheetfor2011,CDCTheovera
5、llprevalencesoftotaldiabetes(previouslydiagnosedpluspreviouslyundiagnoseddiabetes)andprediabeteswere9.7%and15.5%,respectively.Inthemultivariable,multinomial,logitmodels,malesex,olderage,afamilyhistoryofdiabetes,overweight,obesity,centralobesity,increasedheartr
6、ate,elevatedsystolicbloodpressure,elevatedserumtriglyceridelevel,educationallevelbelowcollege,andurbanresidencewereallsignificantlyassociatedwithanincreasedriskofdiabetesandprediabetes.YangetalNEngJMed2010EpidemiologyDiabeticnephropathyisthemostcommoncauseofch
7、ronickidneyfailureandend-stagekidneydiseaseintheUnitedStates,accountingfor44%ofallnewcasesofkidneyfailureintheUnitedStatesin2008.Peoplewithbothtype1andtype2diabetesareatrisk.Theriskishigherifblood-glucoselevelsarepoorlycontrolled.Furthermore,oncenephropathydev
8、elops,thegreatestrateofprogressionisseeninpatientswithpoorcontroloftheirbloodpressure.Alsopeoplewithhighcholesterollevelintheirbloodhavemuchmoreriskthanothers.糖尿病肾病在西方国家是导致慢性肾病和终末期
