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Histomorphologie und Pathogenese der diabetischen Nephropathie

Histomorphology and pathogenesis of diabetic nephropathy

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Zusammenfassung

Diabetes mellitus und Organbeteiligungen bzw. assoziierte Erkrankungen sind insgesamt häufig und zeigen nicht nur in den westlichen Ländern eine zunehmende Inzidenz, sodass sie mittlerweile ein großes weltweites gesundheitspolitisches Problem darstellen. Diabetes mellitus ist v. a. auch deswegen so ernst zu nehmen, da die Inzidenz auch bei Kindern und jungen Erwachsenen bedrohlich zunimmt; Schätzungen gehen davon aus, dass in den USA im Jahr 2025 jedes dritte 2000 geborene Individuum an Diabetes mellitus leiden wird, was langfristig die Lebenserwartung der Bevölkerung dramatisch reduziert. Neben kardiovaskulären Erkrankungen, wie z. B. Bluthochdruck, koronare Herzkrankheit und Schlaganfall, stellt v. a. die Nierenbeteiligung bei Diabetes mellitus, die sog. diabetische Nephropathie (DN), ein zunehmendes und ernsthaftes Problem dar. In Deutschland ist die DN mittlerweile mit etwa 35 % mit weitem Abstand die häufigste Ursache der terminalen Niereninsuffizienz. Im Folgenden soll auf die Pathogenese und Morphologie der DN unter besonderer Berücksichtigung neuer Therapieprinzipien eingegangen werden.

Abstract

Diabetes mellitus and organ involvement or associated diseases are a medical problem worldwide with an ever increasing incidence and prevalence, not only in western countries. Diabetes mellitus must be taken seriously particularly because the incidence in children and young adults is increasing in a threatening way. It is estimated that in the USA by 2025 every third individual born in 2000 will suffer from diabetes, which in the long term will drastically reduce the life expectation of the population. In addition to cardiovascular diseases, such as high blood pressure, coronary heart disease and stroke, the renal involvement in diabetes mellitus, the so-called diabetic nephropathy (DN) in particular represents an increasing and serious problem. In Germany DN now represents with approximately 35% the leading single course by far of end-stage renal disease. This article deals with the pathogenesis and morphology of DN with a special emphasis on new treatment principles.

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Authors and Affiliations

  1. Abt. Nephropathologie, Pathologisches Institut, Universitätsklinikum Erlangen-Nürnberg, Krankenhausstr. 8–10, 91054, Erlangen, Deutschland

    K. Amann & C. Daniel

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  1. K. Amann
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  2. C. Daniel
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Correspondence to K. Amann.

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Interessenkonflikt

K. Amann gibt an, dass kein Interessenkonflikt besteht. C. Daniel erhielt eine Projekt-bezogene Förderung von Boehringer Ingelheim.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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H. Haller, Hannover

G. Wolf, Jena

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Amann, K., Daniel, C. Histomorphologie und Pathogenese der diabetischen Nephropathie. Nephrologe 15, 145–152 (2020). https://doi.org/10.1007/s11560-020-00407-9

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