Kev pheej hmoo cuam tshuam nrog Kev Txhim Kho Mob Raum Ntshav Qab Zib hauv Sudanese Cov Neeg Mob Nrog Hom 2 Ntshav Qab Zib Mellitus

ali.ma@wecistanche.com

Mas MT. Shigidi^{a, *} , Wieam N. Karrar ^b

Abstract:

Keeb kwm thiab lub hom phiaj:Cov ntaub ntawv txwv tsis pub muaj txog cov xwm txheej pheej hmoo cuam tshuam nrog kev txhim kho ntawmmob ntshav qab zib raum(DKD) ntawm Sudanese cov neeg laus uas muaj hom 2 mob ntshav qab zib mellitus (T2DM).Txoj hauv kev: Kev tshawb xyuas cov ntaub ntawv raug coj los ntawm Dr. Salma Center rauKab mob raumLub Plaub Hlis thiab Cuaj Hlis 2019. Cov neeg mob T2DM thiab DKD tau muab piv rau hnub nyoog thiab poj niam txiv neej T2DM cov neeg mob uas tsis muaj mob raum (NKD). Socio-demographic nta, kev kho mob fifindings, thiab kuaj kuaj ntawm cov kev kawm thiab kev tswj tau soj ntsuam siv SPSS.
Cov txiaj ntsig:Tag nrho ntawm 372 tus neeg mob nrog DKD tau muab piv rau 364 T2DM cov neeg mob nrog NKD. Lub hnub nyoog nruab nrab ntawm cov neeg mob DKD yog 58 ± 13.4 xyoo, lawv qhov nruab nrab eGFR yog 37.3 ± 4.9 ml / min / 1.73 m2; lawv muaj lawv T2DM ntawm lub hnub nyoog qis dua piv rau kev tswj hwm (P ¼ 0.014). Logistic regression tsom xam pom tias tsev neeg keeb kwm ntawm ntshav qab zib mellitus, tsev neeg keeb kwm ntawm tus kab mob raum,ntshav siab, rog rog, hypercholesterolemia, hyperuricemia, kev haus luam yeeb, kab mob urinary ib puag ncig, thiab kev siv cov tshuaj uas tsis yog-steroidal anti-inflammatory tau cuam tshuam nrog kev txhim kho ntawm DKD (P qhov tseem ceeb < 0.05).

Xaus:Ib qho ntawm cov kev pheej hmoo hloov pauv tau pom tias yog qhov tseem ceeb rau kev tsim kho KD. Cov kws kho mob tseem ceeb yuav tsum tau ua tib zoo saib xyuas lawv cov kev tswj hwm.

Ntsiab lus: Mob raum mob ntshav qab zib, cov xwm txheej txaus ntshai, Sudan

Nyem rau Cistanche cov teebmeem rau raum kab mob

1. Taw qhia

Tag nrho cov kab mob ntshav qab zib mellitus (DM) hauv Sudan tau kwv yees kwv yees li ntawm 19 feem pua ​​​​hauv cov zej zog hauv nroog thiab 2.5 feem pua ​​​​ntawm cov neeg nyob deb nroog. Nws cia siab tias cov nuj nqis no tseem yuav nce ntxiv raws li qhov nce hauv kev rog, kev laus, tsis muaj lub cev ua si, thiab kev hloov pauv ntawm kev noj haus [1e4].Mob raum mob ntshav qab zib(DKD) yog ib qho teeb meem microvascular ntawm hom 1 thiab hom 2 mob ntshav qab zib, kuaj pom txog li 40 feem pua ​​​​ntawm cov neeg mob uas muaj DM ntev. Nws tshwm sim nyob rau hauv kev kho mob raws li tsis tu ncua proteinuria, nrog ib tug maj mam irreversible txo nyob rau hauv glomerular filtration tus nqi uas ua rau lub raum kab mob kawg (ESRD). Nws tau raug tshaj tawm tias muaj txog li 38.8 feem pua ​​​​ntawm Sudanese cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus (T2DM) [5,6].

Thaum Ntxov DKD yog asymptomatic nrog rau feem coob ntawm cov neeg mob tau kuaj pom cov zis niaj hnub kuaj rau microalbuminuria. Ib qho kev kuaj mob uas nyuam qhuav muaj nyob rau hauv feem ntau qhov chaw kho mob hauv Sudan, vim muaj peev txheej kuaj mob tsawg. Raws li pom nyob rau hauv ntau lub teb chaws tsim, qhov tsis muaj qhov kev tshuaj ntsuam xyuas no tau ua rau feem ntau ntawm cov neeg mob DKD raug kuaj pom lig, thiab tom qab ncav cuag.mob raum mob(CKD) theem 3 lossis 4 [7e9]. Thaum kuaj pom, DKD tseem nyuaj rau thim rov qab thiab feem ntau cuam tshuam nrog kev pom tsis zoo [10]. Nws tseem yog lub luag haujlwm rau ntau dua 13.3 feem pua ​​​​ntawm CKD cov xwm txheej hauv Sudan. Nws yog qhov thib peb feem ntau ua rau cov neeg mob tau lim ntshav [11]. Ntxiv mus, nrog rau tam sim no nce nyob rau hauv qhov kev nthuav dav ntawm DM, nws xav tias DKD yuav dhau los ua tus thawj coj ntawm ESRD hauv Sudan [11,12].

Cov ntaub ntawv txwv tsis pub muaj los ntawm Sudan txog qhov muaj feem cuam tshuam nrog kev txhim kho thiab kev loj hlob ntawm DKD hauv cov neeg mob T2DM. Nws tseem ua tau tias kev txheeb xyuas ntxov ntawm cov neeg mob uas muaj kev pheej hmoo ntawm kev tsim DKD tuaj yeem tso cai rau kev kho mob hnyav thiab yog li hloov qhov kev pheej hmoo rau kev kis tus kab mob ntxiv thiab ncav cuag ESRD [13]. Txoj kev tshawb fawb tam sim no tau ua los tshuaj xyuas cov peev txheej muaj feem cuam tshuam uas txhawb kev txhim kho thiab kev loj hlob ntawm DKD ntawm Sudanese cov neeg laus nrog T2DM ntev.

2. Cov ntaub ntawv thiab cov txheej txheem

Ib txoj kev tshawb fawb txog kev tswj xyuas tau ua nyob rau ntawm Dr. Salma Center rau Kab Mob Raum hauv Khartoum, Sudan. Dr. Salma Center for Kidney Diseases (DSCKD) yog ib lub chaw tshawb fawb hauv tsev kawm qib siab uas muab kev pab rau lub raum rau cov zej zog thiab lees txais kev xa mus los ntawm txhua qhov chaw hauv lub tebchaws. Tag nrho cov neeg laus Sudanese hnub nyoog 35 xyoo thiab siab dua, nrog T2DM rau ntau tshaj 10 xyoo, thiab leej twg tau mus kawm DSCKD qhov chaw kho mob sab nraud rau kev soj ntsuam thaum lub Plaub Hlis 1 txog Lub Cuaj Hli 30, 2019, nrog DKD tau suav nrog hauv txoj kev tshawb no. Cov neeg mob raug cais tawm yog tias lawv muaj hnub nyoog qis dua 35 xyoos, muaj T2DM tsawg dua 10 xyoo, muaj hom 1 lossis theem nrab DM, tsis pom muaj pov thawj ntawm DKD, muaj mob hnyav lossis mob raum mob ntev lossis muaj nephropathy tshwm sim los ntawm lwm yam ua rau. Cov neeg mob kuj raug cais tawm yog tias lawv muaj cov ntaub ntawv kho mob tsis tiav lossis tsis kam lees txais kev tso npe nkag. Kev kuaj mob ntawm T2DM thiab DKD tau ua raws li cov txheej txheem kuaj mob los ntawm American Diabetes Association [14,15]; whereas qhov mob hnyav ntawm CKD thiab nws qhov kev mob tshwm sim tau ua raws li Cov Kab Mob Raum Txhim Kho Kev Txhim Kho Ntiaj Teb (KDIGO) cov lus qhia [15,16].

Socio-demographic, soj ntsuam, thiab kuaj cov ntaub ntawv tau txais los ntawm kev xam phaj ncaj qha ntawm cov neeg mob thiab los ntawm cov neeg mob cov ntaub ntawv kho mob. Ophthalmoscopy tom qab mydriasis tau ua rau txhua tus neeg mob los ntawm tus kws kho qhov muag kom txiav txim siab txog ntshav qab zib retinopathy. Kev ntsuam xyuas plawv tau ua los ntawm tus kws kho plawv kom txiav txim siab txog kab mob plawv ischemic. Cov ntaub ntawv tau los ntawm cov neeg kawm tau muab piv rau cov hnub nyoog thiab pawg tswj hwm kev sib deev, xaiv los ntawm cov chaw kho mob sab nraud ntawm Jabir Abu Eliz Diabetic Center hauv Khartoum, Sudan. Jabir Abu Eliz Diabetic Center (JADC) yog lub tsev kawm tshawb fawb mob ntshav qab zib hauv chaw koom nrog University of Khartoum. Nws lees txais kev xa mus los ntawm yuav luag txhua qhov chaw hauv lub tebchaws. Pawg tswj hwm suav nrog hnub nyoog thiab poj niam txiv neej sib deev Sudanese cov neeg laus, nrog T2DM rau ntau tshaj 10 xyoo, tab sis tsis muaj pov thawj kho mob ntawm mob raum lossis mob raum. Txhua tus neeg mob T2DM suav nrog hauv pawg tswj hwm tau ua raws li JADC tsis tu ncua. Lawv tau kuaj cov zis rau microalbuminuria, kuaj cov zis dipstick thiab zis microscopy, ntshav creatinine qib, thiab glomerular filtration tus nqi kwv yees ua ntej tso npe. Lub xub ntiag ntawm DKD tau txiav txim siab los ntawm qhov tsis muaj micro thiab microalbuminuria hauv cov zis, cov qib ntshav creatinine ib txwm muaj, thiab qhov kwv yees li qub glomerular filtration rate (eGFR) [15e17].

Cov ntaub ntawv tau txais los ntawm kev kawm thiab tswj pawg tau nkag mus rau hauv cov ntaub ntawv txheeb cais rau social sciences (SPSS, Inc., Chicago, IL, USA version 23) computer software. Kev piav qhia rau txhua qhov sib txawv tau ua nrog cov txiaj ntsig tau qhia tias feem pua, txhais tau tias nrog cov qauv sib txawv, lossis cov nruab nrab nrog qhov sib txawv. Chi-square thiab Student's t-tests tau siv rau kev soj ntsuam ntawm categorical thiab cov lej sib txawv, raws li. Uni variate logistic regression tau ua los xam cov kev ntsuas zoo rau tus kab mob, nrog rau qhov sib txawv piv txwv (OR), tus qauv yuam kev, thiab 95 feem pua ​​​​ntawm kev ntseeg siab (CI) tau qhia thiab qhia. Kev txheeb xyuas qhov tseem ceeb tau teeb tsa ntawm P-tus nqi tsawg dua 0.05.

Txoj kev tshawb no tau pom zoo los ntawm Pawg Neeg Saib Xyuas Kev Ncaj Ncees ntawm SudanMedical Specialization Board. Kev ncaj ncees clearance tau txais. Salma Center rauKab mob raumthiab Jabir Abu Eliz DiabeticCenter. Sau ntawv tso cai tau txais los ntawm tag nrho cov neeg koom ua ntej tso npe.

3. Cov txiaj ntsig

Thaum lub sijhawm kawm, tag nrho ntawm 372 tus neeg mob nrog T2DM thiab DKD tau nthuav tawm rau DSCKD rau kev soj ntsuam thiab ua tiav cov kev tshawb fawb suav nrog thiab cais tawm. Ntawm qhov tod tes, 372 hnub nyoog thiab poj niam txiv neej sib tw T2DM cov neeg mob uas tsis muajmob raum(NKD) raug xaiv los ntawm JADC raws li kev tswj hwm. Ntawm cov 8 (2.2 feem pua) cov neeg mob uas thim tawm ntawm txoj kev tshawb no, 364 (97.8 feem pua) pom zoo koom nrog, sawv cev rau pawg tswj hwm.

Lub hnub nyoog nruab nrab ntawm cov neeg mob DKD yog 58 ± 13.4 xyoo, qhov nruab nrab hnub nyoog ntawm lub sijhawm kuaj mob DM yog 44.3 ± 11.2 xyoo. Feem ntau ntawm cov neeg mob DKD tau kawm yog cov txiv neej, paub ntawv, ua haujlwm, sib yuav, thiab los ntawm cheeb tsam nroog (Table 1).

Kev pheej hmoo ntawm cov proteinuria ntawm cov zis dipstick kuaj tau pom tseeb hauv txhua tus neeg mob nrog DKD tau kawm (100 feem pua); nrog rau feem coob ntawm cov neeg mob uas muaj CKD theem 3, 241 (64.7 feem pua). Tsis tas li ntawd, 81 (21.8 feem pua) cov neeg mob DKD tau muaj CKD theem 4, 27 (7.3 feem pua) tau muaj CKD theem 5,14 (3.8 feem pua) tau muaj CKD theem 2, thiab 9 (2.4 feem pua) tau muaj CKD theem 1. nruab nrab eGFR ntawm cov neeg mob T2DM nrog DKD yog 37.3 ± 4.9 ml / min / 1.73 m2. Ntawm qhov tod tes, tsis muaj tus neeg mob T2DM nrog NKD muaj micro lossis macroalbuminuria ntawm kev kuaj zis; lawv cov qib creatinine hauv cov ntshav thiab eGFR qhov tseem ceeb nyob hauv qhov kev siv ib txwm muaj.

Cov qhabnias dhau los ntawm HbA1c tau taug qab hauv cov ntaub ntawv kho mob ntawm cov kev tshawb fawb thiab tswj pawg. Tsuas yog plaub lub xyoos dhau los cov txiaj ntsig tau ua tiav thiab pom hauv cov ntaub ntawv kho mob ntawm 329 (88.4 feem pua) cov neeg mob DKD thiab 285 (78.3 feem pua) cov neeg mob T2DM thiab NKD. Yog li ntawd, qhov nruab nrab HbA1c rau plaub lub xyoos dhau los tau pom tias yog 9.2 ± 4.6 feem pua ​​​​piv rau 8.1 ± 2.4 feem pua ​​​​hauv DKD thiab NKD pawg, raws li (P ¼ 0.04). Logistic regression tsom xam pom tias rog rog, ntshav siab, hyperlipidemia, hyperuricemia, haus luam yeeb, rov tshwm sim urinary tract infection (UTI), thiab kev siv tsis tu ncua ntawm cov tshuaj uas tsis yog-steroidal anti-inflammatory (NSAIDs) tau pom tias yog cov kev pheej hmoo hloov kho rau kev tsim DKD hauv cov neeg mob. nrog ntev-sawv T2DM (Table 2). Tsis tas li ntawd, lwm yam teeb meem microvascular xws li ntshav qab zib retinopathy, neuropathy, thiab peripheral vascular kab mob tau pom dua tias muaj ntau dua nyob rau hauv T2DM muaj DKD thaum piv rau kev tswj, (Table 3).

4. Kev sib tham

Txoj kev tshawb fawb tam sim no tshawb txog qhov muaj feem cuam tshuam nrog kev txhim kho DKD hauv Sudanese cov neeg laus nrog T2DM. Tag nrho ntawm 372 T2DM cov neeg mob uas muaj pov thawj DKD thiab ua raws li niaj zaus ntawm lub raum kev kho mob hauv lub raum hauv Khartoum tau kawm thiab muab piv rau cov neeg mob T2DM ntev nrog NKD, ntawm kev saib xyuas tsis tu ncua. Txhawm rau txo qis qhov cuam tshuam ntawm kev ua yuam kev tsis txaus ntseeg, kev tshawb fawb thiab tswj pawg tau muaj hnub nyoog thiab kev sib deev sib deev. Ob pawg muaj DM rau ntau tshaj 10 xyoo; ib lub sij hawm ntev txaus los sau rau ob pawg ua pawg muaj kev pheej hmoo siab rau kev tsim DKD [18].

Ib txwm muaj qhov sib txawv loj hauv lub hnub nyoog pib ntawm T2DM. Nws tau raug tshaj tawm tias lub sijhawm ntev ntawm DM thiab lub hnub nyoog ntxov ntawm cov kab mob tshwm sim ntau dua qhov kev pheej hmoo ntawm kev tsim DKD [19,20]. Hauv kev tshawb fawb tam sim no, lub hnub nyoog nruab nrab ntawm kev kuaj mob T2DM hauv Sudan yog kwv yees li 45 xyoo thiab cov neeg uas tsim T2DM thaum yau yog qhov muaj feem pheej hmoo ntawm kev tsim DKD.

Feem ntau ntawm cov neeg mob T2DM thiab kev tswj hwm suav nrog hauv txoj kev tshawb fawb no tau nyeem ntawv, ua haujlwm, thiab feem ntau nyob hauv thaj chaw deb nroog. Cov yam ntxwv no tsis sawv cev rau cov pej xeem Sudanese, tab sis lawv qhia txog cov neeg mob uas raug xa mus rau DSCKD thiab ADC. Hauv cov teb chaws tsim kho feem ntau, cov neeg mob uas nrhiav kev kho mob ntxov thiab tau txais cov kev pabcuam tshwj xeeb rau kev saib xyuas yog cov uas muaj peev xwm nkag siab txog qhov ntsiag to ntawm lawv cov kab mob, paub txog nws cov teeb meem, thiab nyob ze rau cov kev pabcuam tshwj xeeb. Tsis tas li ntawd, qhov tsis muaj kev saib xyuas kev noj qab haus huv rau pej xeem thawj zaug rau DKD hauv Sudan tej zaum yuav ua rau cov neeg mob tsawg dua raug xa mus los ntawm cov cheeb tsam nyob deb nroog, thiab tsawg dua cov neeg mob raug xa mus rau CKD thaum ntxov [9]. Feem ntau ntawm peb cov neeg mob DKD tau kawm tau muaj CKD theem 3 lossis 4

Cov kev hloov pauv tseem ceeb tau pom nyob rau hauv kev kho mob ntawm T2DM hauv kev tshawb fawb thiab tswj cov pab pawg, nrog rau feem pua ​​​​ntawm cov neeg mob DKD tau tswj hwm ntawm insulin ntau dua. Feem ntau cov tshuaj hypoglycemic ntawm qhov ncauj muaj nyob rau hauv Sudan tsis tuaj yeem siv yam xyuam xim rau cov neeg mob CKD 3, 4, thiab 5. Yog li, cov tshuaj no yuav tsum tau muab tshem tawm, hloov mus rau insulin, lossis lawv cov koob tshuaj raug hloov kho; Nco ntsoov tias cov tshuaj insulin feem ntau muaj kev nyab xeeb dua hauv cov neeg mob CKD [21]. Qhov no tej zaum yuav ua pov thawj qhov sib txawv ntawm kev tswj xyuas T2DM hauv cov neeg mob uas muaj thiab tsis muaj DKD.
Nyob rau hauv txoj kev tshawb no tam sim no, peb pom cov qib siab ntawm HbA1c tsis tu ncua nyob rau hauv ob qho tib si kev tshawb fawb thiab tswj pawg, feem ntau yog vim tsis ua raws li kev kho mob [20,22]. Qhov tseem ceeb ntau dua ntawm HbA1c tau tshwm sim hauv cov neeg uas muaj DKD piv rau kev tswj hwm. Cov kev tshawb pom no tau ua raws li cov ntaub ntawv dhau los, uas tau pom tias muaj HbA1c siab hauv cov neeg mob DKD; qhov kev tswj glycemic zoo tau pom tias cuam tshuam nrog kev pheej hmoo tsawg dua ntawm kev tsim DKD [18].

Lub xub ntiag ntawm tsev neeg sib sau ua ke ntawm DKD thiab mob ntshav qab zib ESRD tau tshaj tawm, txhawb nqa qhov muaj kev cuam tshuam ntawm caj ces rau kev tsim DKD hauv cov neeg mob T2DM. Tsev neeg keeb kwm ntawm DKD tau raug tshaj tawm dua li qhov muaj feem cuam tshuam rau kev tsim DKD [23,24]. Hauv kev tshawb fawb tam sim no, tsev neeg keeb kwm ntawm T2DM thiab tsev neeg keeb kwm ntawm CKD ob leeg pom tias yog qhov muaj feem pheej hmoo rau kev tsim DKD.

Kev rog dhau tau raug txheeb xyuas ntau zaus raws li qhov muaj feem cuam tshuam rau kev tsim T2DM. Nws tau raug tshaj tawm tias tshwm sim hauv 24.5 feem pua ​​​​ntawm Sudanese cov neeg mob uas muaj T2DM [1,25]. Hauv kev tshawb fawb tam sim no thiab zoo ib yam li cov ntawv tshaj tawm dhau los, kev rog rog, hyperlipidemia, hyperuricemia, thiab kev haus luam yeeb tau pom tias yog qhov tseem ceeb rau kev tsim DKD rau cov neeg mob uas muaj T2DM ntev. Cov tseem yuav hloov pauv tau qhov kev pheej hmoo thiab lawv cov kev tswj xyuas nruj yuav tsum ua kom qeeb ntawm DKD [18,19,25e28].

Kev siv NSAIDs ntau zaus tau tshaj tawm yav dhau los los txhim kho lub raum kev ua haujlwm tsis zoo hauv cov neeg mob DKD [29]. Tsis tas li ntawd, cov neeg mob uas muaj T2DM ntev ntev tau paub tias muaj kev pheej hmoo rau kev tsim rov tshwm sim thiab muaj teeb meem ntawm cov kab mob urinary tract (UTI), uas ua rau lub raum ua haujlwm tsis zoo [30]. Hauv txoj kev tshawb fawb tam sim no, ob qho tib si nquag siv NSAIDs thiab rov tshwm sim UTIs tau cuam tshuam nrog kev txhim kho DKD. Ntev NSAIDs feem ntau yog siv rau qhov mob nraub qaum thiab osteoarthritis hauv 84 feem pua ​​​​ntawm cov neeg mob tau kawm. Hauv cov neeg mob uas muaj T2DM, cov tshuaj tsis tu ncua ntawm cov tshuaj no yuav tsum tau txiav txim siab tsuas yog tom qab kev soj ntsuam ceev faj txog lawv cov txiaj ntsig thiab kev pheej hmoo. Ib zaug ntxiv, cov tsos mob rov tshwm sim dua UTIs yuav tsum tau tswj tam sim hauv cov neeg mob uas muaj T2DM ntev thiab DKD [31].

Kev lig kev cai, muaj DKD ib txwm cuam tshuam nrog retinopathy, neuropathy, thiab lwm yam mob ntshav qab zib mellitus [32e34]. Qhov tshwm sim ntau dua ntawm retinopathy, neuropathy, thiab peripheral vascular tau pom nyob rau hauv cov neeg mob nrog DKD piv rau kev tswj. Tsis muaj qhov sib txawv tseem ceeb ntawm cov pab pawg hais txog qhov muaj cov kab mob plawv ischemic. Qhov ntawd zoo li yog vim muaj hnub nyoog qis dua ntawm kev kawm thiab tswj pawg; Cov kab mob plawv ischemic tau tshaj tawm tias muaj ntau dua nyob rau hauv cov neeg siab dua 70 xyoo [35].

Cov neeg mob T2DM yuav tsum tau kuaj xyuas microalbuminuria tom qab tsib xyoos ntawm lawv qhov kev kuaj mob thawj zaug, thiab tom qab ntawd txhua xyoo. Kev tshuaj xyuas yog ua tiav los ntawm kev kuaj cov zis rau albumin / creatinine piv, saib xyuas qib creatinine hauv cov ntshav, thiab kev kwv yees ntawm GFR. Kev hloov pauv cov kev pheej hmoo cuam tshuam nrog kev txhim kho ntawm DKD yuav tsum tau tsom mus rau ncua kev nce qib ntawm DKD; uas suav nrog kev hloov pauv hauv kev ua neej, ua kom zoo dua glycemic tswj, tswj ntshav siab, txo qis lipoprotein tsawg, thiab siv angiotensin-hloov enzyme inhibitors lossis angiotensin II receptor blockers hauv cov neeg uas muaj cov proteinuria pom tseeb [5,15].

Txoj kev tshawb fawb tam sim no tau txwv los ntawm nws qhov kev rov qab los, ua ib qho kev qhib-labeled, ib qho kev kawm hauv ib qho chaw, nrog cov neeg mob tsawg tsawg. Cov xwm txheej no tuaj yeem ua rau muaj kev xaiv tsis ncaj ncees uas tsis tuaj yeem zam, tso cai rau kev ua tsis ncaj ncees lawm, thiab cov txiaj ntsig tau txais tsis tuaj yeem yog qhov dav dav.

5. Cov lus xaus

Txoj kev tshawb no tsom rau cov neeg laus Sudanese uas muaj hom 2 DM thiab DKD. Ntau yam kev pheej hmoo tau pom los txhawb kev txhim kho DKD hauv cov neeg mob uas muaj T2DM ntev. Kev tswj tsis tau DM, tsev neeg keeb kwm ntawm DM, tsev neeg keeb kwm ntawm CKD, muaj kev rog rog, kub siab, ntshav siab tag nrho cov roj cholesterol, hyperuricemia, haus luam yeeb, rov tshwm sim UTI, thiab nquag siv NSAIDs txhua tus tau pom tias muaj zog txiav txim siab rau kev tsim DKD. . Feem ntau ntawm cov teeb meem kev pheej hmoo yog hloov tau thiab lawv txoj kev tswj hwm yuav tsum txo lossis ncua kev txhim kho ntawm DKD. Cov kws kho mob yuav tsum tau ua tib zoo saib xyuas lawv hauv kev tswj hwm ntawm T2DM [18].

Tshaj tawm ntawm kev sib tw txaus siab

Cov neeg sau ntawv tsis muaj teeb meem ntawm kev txaus siab los tshaj tawm.

Cov ntaub ntawv

[1] Elmadhoun WM, Noor SK, Ibrahim AA, Bushara SO, Ahmed MH. Kev pheej hmoo ntawm ntshav qab zib mellitus thiab nws cov xwm txheej txaus ntshai hauv cov zej zog hauv nroog ntawm sab qaum teb Sudan: kev tshawb fawb pej xeem. J Diabetes 2016; 8(6):839e84.
[2] Noor SK, Bushara SO, Sulaiman AA, Elmadhoun WM, Ahmed MH. Mob ntshav qab zib mellitus uas tsis tau kuaj pom hauv cov zej zog nyob deb nroog hauv Sudan: qhov muaj feem ntau thiab muaj feem cuam tshuam. East Mediterr Health J 2015;21(3):164e70.
[3] Popkin BM, Adair LS, Shu Wen NG. Kev hloov pauv khoom noj khoom haus thoob ntiaj teb thiab kev sib kis ntawm kev rog rog hauv cov tebchaws tsim. Nutr Rev 2012;70(1):3e21.
[4] El-Sayed EF, Awadalla H, Noor SK, et al. Kev noj qab haus huv hauv Sudanese cov tib neeg tau cuam tshuam nrog qee yam ntawm cov kab mob metabolic: pej xeem raws li kev tshawb fawb. Diabetes Metab Syndr 2018; 12:245e50.
[5] National Raum Foundation. KDOQI cov lus qhia txog kev kho mob ntshav qab zib thiab CKD: 2012 hloov tshiab. Am J Raum Dis 2012;60:850e86.[6] Hussein M, Menasri S. Prevalence of microvascular complications in type 2 diabetes mus koom lub chaw saib xyuas kev noj qab haus huv hauv Sudan. Int J Diabetes Metabol 2019; 25:127e33.
[7] Molitch ME, Adler AI, Flyvbjerg A, et al. Mob raum mob ntshav qab zib mellitus: kho kho tshiab los ntawm kab mob raum: Txhim kho Cov txiaj ntsig thoob ntiaj teb. Raum Int 2015; 87: 20e30.
[8] Janmohamed MN, Kalluvya SE, Mueller A, Kabalinga R, Smart LR, Downs JA, Peck RN. Feem ntau ntawm cov kab mob raum ntev hauv cov neeg laus mob ntshav qab zib hauv Tanzania. BMC Nephrol 2013; 14:183.
[9] Shigidi M, Ebrahim S, Karrar W. Ib qho kev tshuaj xyuas ntawm cov neeg mob uas mob raum mob uas nyuam qhuav raug xa mus rau lub raum tshwj xeeb hauv Sudan. Afr J Nephrol 2021; 24(1):12e8.
[10] Chang TY, Park JW, Kim JK, Kim HJ, Yoo HJ, et al. Cov txiaj ntsig ntawm lub raum hauv cov neeg mob uas muaj ntshav qab zib hom 2 nrog lossis tsis muaj kev sib koom ua ke uas tsis yog mob ntshav qab zib raum. Diabetes Res Clin Pract 2011; 92:198e204.
[11] Shigidi M, Abdelgafar H, Taha E. Kev paub txog kev tswj ntshav qab zib thiab mob ntshav qab zib nephropathy ntawm Sudanese cov neeg laus tau txais cov mob ntshav qab zib ko taw: kev kawm hla ntu. Pan Afr Med J 2013; 16(157).
[12] Locatelli F, Canaud B, Eckardt KU, et al. Qhov tseem ceeb ntawm ntshav qab zib nephropathy nyob rau hauv kev xyaum nephrological tam sim no. Nephrol Dial Transplant 2003; 18(9): 1716e25.
[13] Nata N, Rangsin R, Supasyndh O, Satirapoj B. Impaired glomerular filtration rate nyob rau hauv hom 2 mob ntshav qab zib mellitus cov ntsiab lus: kev kawm hla teb chaws hauv Thaib teb. J Diabetes Res 2020: 6353949.
[14] American Diabetes Association. Kev faib tawm thiab kev kuaj mob ntshav qab zib: cov qauv kev kho mob hauv ntshav qab zib. Diabetes Care 2019;42(Suppl 1): S13e28.
[15] Levin A, Stevens P, Bilous RW, Coresh J, de Francisco ALM, De Jong PE, et al. Kab mob raum: Txhim kho Cov txiaj ntsig thoob ntiaj teb (KDIGO) CKD Ua Haujlwm Pab Pawg. KDIGO 2012 daim ntawv qhia kev kho mob rau kev ntsuam xyuas thiab kev tswj cov kab mob raum ntev. Raum Int Suppl 2013;3(1):1e150.

[16] Levey AS, Stevens LA, Schmid CH, Zhang Y, Castro AF, Feldman HI, et al. CKDEPI (Kev sib koom ua ke ntawm Kab mob raum raum). Ib qho kev sib npaug tshiab los kwv yees glomerular filtration rate [tso tawm kho pom hauv Ann Intern Med. 408 Ann Intern Med 2011;155(6):604e12. 2009; 150(9).

[17] Kassab A, Ajmi T, Issaoui M, Chaeib L, Miled A, Hammami M. Homocysteine ​​txhim kho LDL fatty acid peroxidation, txhawb microalbuminuria hauv hom 2 mob ntshav qab zib. Ann Clin Biochem 2008; 45:476e80.

[18] Tziomalos K, Athyros VG. Mob ntshav qab zib nephropathy: cov yam ntxwv tshiab thiab kev txhim kho hauv kev kuaj mob. Rev Diabet Stud 2015; 12:110e8.
[19] Viswanathan V, Tilak P, Kumpatla S. Risk yam cuam tshuam nrog kev loj hlob ntawm overt nephropathy nyob rau hauv cov neeg mob ntshav qab zib hom 2: kev soj ntsuam 12 xyoo. Indian J Med Res 2012;136(1):46e53.
[20] Awadalla H, Noor SK, Elmadhoun WM, Almobarak AO, Elmak NE, Abdelaziz SI, Sulaiman AA, Ahmed MH. Mob ntshav qab zib muaj teeb meem hauv Sudanese cov tib neeg uas muaj ntshav qab zib hom 2: saib tsis pom teeb meem hauv sub-Saharan Africa? Diabetes Metab Syndr 2017;11(Suppl 2):S1047e51.
[21] Hahr Allison J, Molitch Mark E. Kev tswj cov ntshav qab zib mellitus hauv cov neeg mob mob raum. Clin Diabetes Endocrinol 2015; 1:2.
[22] Khogali SS, Ali WA, Mohamed SY, Abdelrahim HE, Mirhani AA, Ali RH, Jailani M, Omer BM, Ibrahim NA, Ahmed MH. Kev paub, tus cwj pwm thiab kev coj ua ntawm Sudanese cov neeg mob ntshav qab zib hom 2 txog cov tshuaj siv hauv kev kho mob ntshav qab zib, kub siab thiab dyslipidemia: teeb meem kev sib cav lossis teeb meem kev txhawj xeeb? J Public Health Emerg 2018; 2:23.
[23] Fu H, Liu S, Bastacky SI, Wang X, Tian XJ, Zhou D. Mob raum mob ntshav qab zib revisited: qhov kev xav tshiab rau lub sijhawm tshiab. Molecular Metabolism 2019; (30): 250e63.
[24] Wang Y, Zhao J, Zhang J, Wu Y, Zhang R, Li Guo R, et al. Kev cuam tshuam ntawm tsev neeg keeb kwm ntawm ntshav qab zib thiab kev poob qis sai ntawm eGFR hauv cov neeg mob uas muaj ntshav qab zib hom 2 thiab cov kab mob ntshav qab zib biopsy-proven diabetic raum. Pem hauv ntej Endocrinol 2019; 10: 855.
[25] Ali YA, Almobarak AO, Awadalla H, Elmadhoun WM, Ahmed MH. Kev rog rog ntawm Sudanese cov neeg laus uas muaj ntshav qab zib: kev soj ntsuam ntawm pej xeem. Ann Transl Med 2017;5(12:252.
[26] Zhu P, Liu Y, Han L, Xu G, Ran JM. Serum uric acid yog txuam nrog qhov xwm txheej mob raum mob hauv cov neeg laus hnub nyoog nruab nrab: ib qho kev tshuaj ntsuam xyuas ntawm 15 pawg kev tshawb fawb. PLoS Ib 2014; 9(6):e100801.
[27] Zheng W, Chen L. Factor tsom xam ntawm ntshav qab zib nephropathy hauv Suav cov neeg mob. Diabetes Metab Syndr 2011;5(3):130e6.
[28] Chuahirun T, Khanna A, Kimball K, Wesson DE. Kev haus luam yeeb thiab tso zis ntau ntxiv albumin excretion yog qhov cuam tshuam txog kev kwv yees ntawm kev mob ntshav qab zib nephropathy hauv hom 2 mob ntshav qab zib. Am J Raum Dis 2003;41(1):13e21.
[29] Tsai HJ, Hsu YH, Huang YW, Chang YK, Liu JS, Hu CC. Kev siv cov tshuaj uas tsis yog-steroidal los tiv thaiv kab mob thiab kev pheej hmoo ntawm mob raum mob rau cov neeg mob ntshav qab zib hom 2, kev tshawb fawb thoob teb chaws longitudinal cohort. Diabet Med 2015;32(3):382e90.
[30] Lee HJ, Lee HJ, Lim HJ, Li HJ, Li HJ, Koo JH, et al. Pyuria, kab mob urinary ib ntsuj av thiab lub raum tshwm sim nyob rau hauv cov neeg mob uas mob raum kab mob theem 3e5. Sci Rep 2020; 10:19460.
[31] Nitzan O, Elias M, Chazan B, Saliba W. Urinary tract infections nyob rau hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus: kev tshuaj xyuas ntawm kev nthuav dav, kev kuaj mob, thiab kev tswj xyuas. Diabetes Metab Syndr Obes 2015; 8:129e36.
[32] Shi R, Niu R, Wu B, et al. Nomogram rau kev pheej hmoo ntawm mob ntshav qab zib nephropathy lossis ntshav qab zib retinopathy ntawm cov neeg mob uas muaj ntshav qab zib hom 2 raws li daim ntawv nug thiab cov cim qhia txog biochemical: kev tshawb nrhiav ntu ntu. Diabetes Metab Syndr Obes 2020; 13:1215e29.
[33] Jiang S, Fang J, Yu T, Liu L, Zou G, Zhuo L, et al. Novel qauv kwv yees mob ntshav qab zib nephropathy hauv hom 2 mob ntshav qab zib. Am J Nephrol 2020;51(2):130e8.
[34] Hu F, Zhang T. Kev tshawb fawb txog cov xwm txheej ntawm cov ntshav qab zib nephropathy hauv cov neeg rog rog uas muaj hom 2 mob ntshav qab zib mellitus. Int J Gen Med 2020; 13:351e60.
[35] Sakboonyarat B, Rangsin R. Prevalence thiab txuam yam ntawm cov kab mob plawv ischemic (IHD) ntawm cov neeg mob ntshav qab zib mellitus: ib qho kev tshawb fawb thoob teb chaws, hla ntu. BMC Cardiovasc Disord 2018; 18:151.