대한신장학회

논문분류	춘계학술대회 초록집
제목	Diabetic Kidney Diseases: A Taiwan Nephrologist’s Observations on Unmet Issues
저자	Jin-Shuen Chen
출판정보	2019; 2019(1):
키워드	diabetic kidney nephropathy
초록	Diabetic kidney diseases (DKD) and diabetic nephropathy (DN) are the leading causes of end-stage renal disease (ESRD), contributing to heavy medical costs in Taiwan and most developed countries. Researchers around the world, particularly endocrinologists, nephrologists and associated medical personnel, are working to manage the disease; however, many unmet issues remain regarding this complex and difficult-to-treat disease. First of all, in recent decades, Taiwan’s government and medical societies have made strong efforts to manage DKD. All our efforts will be summarized in my lecture. Furthermore, in this lecture, the definition, epidemiology, diagnosis, mechanism, treatment and prognosis of DN will be discussed according to data from Taiwan and the rest of the world. Some of the major unmet issues in DN research will be presented. The first issue is the current problems in early DN-glomerular hyperfiltration; current research on the relationship between glomerular hyperfiltration and ESRD will be presented. The second issue is current problems of diagnosis of DN, and the difference, 1) between pathological and clinical diagnosis for DN; and 2) between DN and DKD, will be discussed. The third issue concerns the current pathogenesis of DN; factors from diabetic mellitus contributing to development of DN will be discussed. Some unmet issues from endocrinologists and cardiologists will be discussed. The fourth issue is current treatment of DN, and precision medicine and care will be proposed. All unmet issues discussed in this lecture will be integrated with the findings from my studies, and potential directions for physicians and researchers will be suggested. References: 1. Chen JS et al, Chaperonin-containing t-complex protein-1 subunit β as a possible biomarker for the phase of glomerular hyperfiltration of diabetic nephropathy. Dis Markers 2015:2015:548101. 2. Chen JS et al, Urokinase plasminogen activator receptor and its soluble form in common biopsy-proven kidney diseases and in staging of diabetic nephropathy. Clin Biochem 2015 Dec;48(18): 1324-9. 3. Chen JS et al, Association among Fibrinolytic Proteins, Metabolic Syndrome Components, Insulin Secretion, and Resistance in Schoolchildren. Int J Endocrinol 2015;2015:170987. 4. Chen JS et al, Significance of the urokinase-type plasminogen activator and its receptor in the progression of focal segmental glomerulosclerosis in clinical and mouse models. J Biomed Sci 2016 Feb 4;23:24. 5. Chen JS et al, Serum ApoA4 levels predicted the progression of renal impairment in T2DM. Eur J Clin Invest 2018 Jun;48(6):e12937. 6. Sandman L et al. Why we don’t need”unmet needs”!On the concepts of Unmet need and severity in health-care priority setting. Health Care Analysis 2019:27:26 7. Gomerz LA et al. The diabetes pandemic suggests unmet needs for “CKD with diabetes” in addition to “diabetic nephropathy”- implications for pre-clinical research and drug testing. Nephrol Dial Transplant 2018:33:1292 8. Umanath K et al. Update on diabetic nephropathy: core curriculum 2018. Am J Kidney Disease 2018:71:884
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