糖尿病性肾病是指发生于糖尿病基础上的肾脏病。有广义和狭义之分,广义泛指糖尿病而引起的一切肾脏病。包括糖尿病性肾血管病(包括微血管和大血管病)和感染(如肾盂肾炎等),狭义则专指肾脏微血管病,本文主要阐述狭义的糖尿病性肾病。发病率:由于诊断方法,诊断标准及诊断时间不同,各家报道各异。肯定的是糖尿病性肾病的发病率随糖尿病的病程增加而增加。病程在20年以上的胰岛素依赖型糖尿病(IDD),80～100%有糖尿病性肾小球硬化。也有人认为,糖尿病病程与糖尿病性肾病的发生并非绝对相关。有人观察了90例糖尿病肾病,其中71例病程不足10年。病程不足一年的糖尿病患者,39.1%有肾病表现。三军医大对20例临床上无肾病表现的糖尿病人进行了肾活检,发现100%有肾小球硬化。在美国,由糖尿病性肾病引起的终末期肾衰占替代治疗的25%(1982),日本为15.6%。近年报道糖尿 Diabetic nephropathy refers to the kidney disease that occurs on the basis of diabetes. There are broad and narrow sense, a broad term refers to all diabetes caused by kidney disease. Including diabetic renal disease (including microvascular and macrovascular disease) and infection (such as pyelonephritis, etc.), the narrow sense of the special refers to renal microangiopathy, this article describes the narrow sense of diabetic nephropathy. Incidence: Due to diagnostic methods, diagnostic criteria and diagnosis of different time, various reports vary. It is certain that the incidence of diabetic nephropathy increases with the duration of diabetes. Over 20 years of insulin-dependent diabetes mellitus (IDD), 80-100% have diabetic glomerulosclerosis. Some people think that the course of diabetes and diabetic nephropathy is not absolutely relevant. Someone observed 90 cases of diabetic nephropathy, of which 71 cases less than 10 years duration. Diabetic patients with less than one year duration, 39.1% had kidney disease. Military Medical University of the 20 cases of clinical manifestations of non-diabetic patients with renal biopsy and found that 100% had glomerulosclerosis. In the United States, end-stage renal failure due to diabetic nephropathy accounts for 25% of the replacement therapy (1982) and in Japan 15.6%. Diabetes reported in recent years