What Not to Overlook in the Management of Patients with Type 2 Diabetes Mellitus: The Nephrological and Hepatological Perspectives

被引:1
|
作者
Alfieri, Carlo Maria [1 ,2 ]
Molinari, Paolo [1 ,3 ]
Cinque, Felice [4 ,5 ]
Vettoretti, Simone [1 ]
Cespiati, Annalisa [4 ,5 ]
Bignamini, Daniela [4 ]
Nardelli, Luca [1 ,2 ]
Fracanzani, Anna Ludovica [4 ,5 ]
Castellano, Giuseppe [1 ,2 ]
Lombardi, Rosa [4 ,5 ]
机构
[1] Fdn IRCCS CaGranda Osped Policlin, Dept Nephrol Dial & Renal Transplantat, I-20122 Milan, Italy
[2] Univ Milan, Dept Clin Sci & Community Hlth, I-20122 Milan, Italy
[3] Univ Milan, Postgrad Sch Specializat Nephrol, I-20122 Milan, Italy
[4] Fdn IRCCS CaGranda Osped Maggiore Policlin Milano, SC Med Indirizzo Metab, I-20122 Milan, Italy
[5] Univ Milan, Dept Pathophysiol & Transplantat, I-20122 Milan, Italy
关键词
chronic kidney disease; diabetic kidney disease; metabolic dysfunction-associated steatotic liver disease; liver fibrosis; hyperfiltration; FATTY LIVER-DISEASE; CHRONIC KIDNEY-DISEASE; CONTROLLED-TRIAL; WEIGHT-LOSS; EPIDEMIOLOGY; SUSCEPTIBILITY; PREVALENCE; FEATURES; UPDATE; NAFLD;
D O I
10.3390/ijms25147728
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Diabetes mellitus (DM) significantly impacts renal and hepatic function, necessitating comprehensive understanding and management strategies. Renal involvement, namely diabetic kidney disease (DKD), presents a global challenge, with increasing prevalence paralleling DM rates. Lifestyle modifications and pharmacotherapy targeting hypertension and glycemic control have pivotal roles in DKD management. Concurrently, hepatic involvement in DM, characterized by metabolic dysfunction-associated steatotic liver disease (MASLD), presents a bidirectional relationship. DM exacerbates MASLD progression, while MASLD predisposes to DM development and worsens glycemic control. Screening for MASLD in DM patients is of high importance, utilizing non-invasive methods like ultrasound and fibrosis scores. Lifestyle modifications, such as weight loss and a Mediterranean diet, mitigate MASLD progression. Promising pharmacotherapies, like SGLT2 inhibitors and GLP-1 agonists, demonstrate efficacy in both DM and MASLD management. Special populations, such as diabetic individuals undergoing hemodialysis or kidney transplant recipients, demand special care due to unique clinical features. Similarly, DM exacerbates complications in MASLD patients, elevating the risks of hepatic decompensation and hepatocellular carcinoma. Recognizing the interconnectedness of DM, renal, and hepatic diseases underscores the need for multidisciplinary approaches for optimal patient outcomes. The present review aims to present the main characteristics and crucial points not to be overlooked regarding the renal and hepatic involvement in DM patients focusing on the inter-relationships between the renal and the hepatic involvements.
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页数:23
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