P中国全科医学2023年4月第26卷第12期htps:∥iace.china.ne4E-mai让ggk@chinagpnet.cm·1415,指南解读·2022版《ADA/KDIGO共识报告：慢性肾脏病患者的糖尿病管理》要点解读扫描二维码姚慧娟，杨宇，徐阿晶查看原文【摘要】糖尿病和慢性肾脏病(CK①)患者是肾衰竭、动脉粥样硬化性心血管疾病、心力衰竭和过早死亡的高危人群。美国糖尿病协会(ADA)和改善全球肾脏病预后组织(KDIG0)成立联合专家小组，根据ADA2022年发布的糖尿病管理标准和KDIG02022年发布的《KDIG0临床实践指南：慢性肾脏病患者的糖尿病管理》中基于证据的CK①患者糖尿病管理建议进行整合，形成了2022版《ADA/KDIG0共识报告：慢性肾脏病患者的糖尿病管理》（简称共识)。该共识不仅重新强调了已发布指南更新的CK①D筛查和诊断、血糖监测、生活方式干预、治疗目标和药物管理内容，还特别强调了健康生活方式基础上的药物治疗综合管理的重要性。该共识声明了7项核心建议，对肾素-血管紧张素系统抑制剂、二甲双肌、钠-葡萄糖共转运蛋白-2抑制剂、胰高血糖素样肽1受体激动剂和非甾体盐皮质激素受体拮抗剂的使用提供了具体指导，为改善糖尿病合并CK①患者临床结局的管理提供了明确方向。本文对该共识的主要内容进行解读，以期为临床医生提供简洁、实用的指导，改善糖尿病合并CK①患者的预后。【关键词】慢性肾脏病；糖尿病；血糖监测；诊断；药物治疗；指南解读【中图分类号】R692.5R587.1【文献标识码】AD0L:10.12114.issn.1007-9572.2023.0015姚慧娟，杨宇，徐阿品.2022版《ADA/KDIG0共识报告：慢性肾脏病患者的糖尿病管理》要点解读[J].中国全科医学，2023,26(12)：1415-1421.[www.chin.net]YAO H J,YANG Y,XU A J.Interpretation of Diabetes Management in Chronic Kidney Disease:a Consensus Report bythe American Diabetes Association (ADA)and Kidney Disease:Improving Global Outcomes (KDIGO)[J].Chinese GeneralPractice,2023,26(12):1415-1421.Interpretation of Diabetes Management in Chronic Kidney Disease:a Consensus Report by the American DiabetesAssociation (ADA and Kidney Disease:Improving Global Outcomes KDIGO YAO Huijuan,YANG Yu,XUAjingDepartment of Clinical Medicine,Xinhua Hospital Affiliated to Shanghai Jiao Tong Unirersity School of Medicine,Shanghai200092,China"Corresponding author:XU Ajing,Chief pharmacist;E-mail:xuajing@xinhuamed.com.cnAbstract People with diabetes and chronic kidney disease (CKD)are at high risk for kidney failure,atherosclerotic cardiovascular disease,heart failure,and premature mortality.The American Diabetes Association (ADAand the Kidney Disease:Improving Global Outcomes (KDIGO established joint group,and integration of evidence-basedrecommendations for diabetes management in patients with CKD in accordance with the ADA 2022 standards of medical care indiabetes and KDIGO 2022 Clinical Practice Guideline for Diabetes Management in CKD,and to form the Diabetes Managementin Chronic Kidney Disease:a Consensus Report by the ADA and KDIGO.The consensus not only re-emphasizes the publishedguidelines for screening and diagnosis of CKD,glycemia monitoring,lifestyle therapies,treatment goals,and pharmacologicmanagement,but also specifically emphasizes the importance of comprehensive care in which pharmacotherapy based on afoundation of healthy lifestyle.The consensus states seven core recommendations which provide specific guidance for the useof renin-angiotensin system inhibitors,metformin,sodium-glucose cotransporter-2 inhibitors,glucagon-like peptide 1receptor agonists,and a nonsteroidal mineral corticoid receptor antagonist.These areas of consensus provide clear directionfor implementation of care to improve clinical outcomes of people with diabetes and CKD.Focusing on the main contents of theconsensus,we interpreted main recommendations in order to provide concise and practical guidance for clinicians,to achieve the基金项目：国家重点研发计划项目(2020YF
