Lancet Diabetes Endocrinol杂志的个人观点栏目近期发表了一篇文章,提出2型糖尿病肾功能损伤的“无蛋白尿途径”。长期以来,大多数基于1型糖尿病的数据显示,糖尿病肾病的自然病程分为三个阶段:正常白蛋白尿期、微量白蛋白尿期和大量白蛋白尿期。肾小球高滤过是早期肾病的标志,肾小球滤过率(GFR)进行性下降被认为是起始于大量蛋白尿期(显性肾病)。然 A recent article in the personal opinion section of the Lancet Diabetes Endocrinol magazine suggests a “proteinuria-free approach” for renal impairment in type 2 diabetes. For a long time, most data based on type 1 diabetes showed that the natural history of diabetic nephropathy is divided into three phases: normal albuminuria, microalbuminuria, and extensive albuminuria. Glomerular hyperfiltration is a hallmark of early nephropathy and a progressive decline in glomerular filtration rate (GFR) is thought to start in large numbers of proteinuria (dominant kidney disease). Of course