牛建英 陈瑜

    摘 要 糖尿病肾脏疾病已成为全球终末期肾脏病的最主要病因之一。对2型糖尿病合并慢性肾脏病患者这一特殊人群，规范诊疗、合理用药、细化管理等问题仍有待解决。随着新型降血糖药物的上市和应用，2型糖尿病合并慢性肾脏病的治疗策略不断更新。严格控制血糖可有效延缓糖尿病肾脏疾病的发生和发展。然而，随着肾功能减退，患者体内降血糖药物蓄积，药物不良反应和低血糖事件会增加。所以，2型糖尿病合并慢性肾脏病患者如何有效且安全地使用降血糖药物至关重要。本文依据国内外相关临床指南和专家共识，就2型糖尿病合并慢性肾脏病患者治疗的口服降血糖药物选择及剂量调整要求作一概要介绍。

    关键词 2型糖尿病 口服降血糖药物 合理用药

    中图分类号：R977.15； R969.3 文献标志码：A 文章编号：1006-1533(2022)03-0025-04

    Selection and dosage adjustments of oral antidiabetic drugs in type 2 diabetes patients with chronic kidney disease

    NIU Jianying， CHEN Yu

    (Division of Nephrology， Shanghai Fifth People’s Hospital， Fudan University， Shanghai 200240， China)

    ABSTRACT Diabetic kidney disease (DKD) has become one of the main causes of end-stage renal disease in the world. For the special group of patients with type 2 diabetes and chronic kidney disease (CKD)， the issues such as standardized diagnosis and treatment， rational drug use， and detailed management still remain to be solved. In addition， with the launch and clinical application of new antidiabetic drugs， the treatment strategy for type 2 diabetes with CKD has been continuously updated. Strict control of blood glucose can effectively reduce the occurrence and progression of DKD. However ......