@article{oai:niigata-u.repo.nii.ac.jp:00016371,
 author = {柄澤, 良 and 鈴木, 芳樹 and 笠井, 昭男 and 阪田, 郁 and 成田, 一衛 and 荒川, 正昭},
 issue = {10},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Oct},
 note = {The number of diabetic patients suffering from end stage renal disease is increasing year by year. It is important to prevent and postpone the initiation and progression of diabetic nephropathy (DN). The purpose of this review is to discuss preventive treatment in the field of DN. The target of glycemic control is reported such as below 7.2 % and 6.5 % in serum HbA1c level in IDDM and NIDDM patients, respectively. Since it is difficult to achieve these targets, aldose reductase inhibitor, protein kinase C-β inhibitor and other drugs such as aminoguanidine may be a treatment which can compensate incomplete glycemic control. Concerning to glomerular hyperfiltration, ACE inhibitor (ACEI) is more beneficial among antihypertensive agents. Since recommended target level of blood pressure (BP) is below 130/85 mmHg (JNC VI), it is difficult to control BP using only ACEI, and then combination with other antihypertensive drugs will be necessary in many cases. The preventive effects of dietary protein restriction in the progeression of DN will be proven by prospective controlled multicenter-study. Administration of prostaglandin (PG) E1, PGI2, and pancreatic elastase (PE) induce the reduction of urinary albumin excretion rate (UAER) in some patients with DN. Long term effect of these agents remains to be investigated. Glycosaminoglycans (GAGs) including heparin is reported to reduce UAER in human and animal models of DN. GAGs with low anticoagulation action is necessary for clinical use. Concerning the clinical stage of DN, therapeutic approach to DN is summarized.},
 pages = {602--606},
 title = {2)糖尿病性腎症の治療（シンポジウム　糖尿病合併症の治療, 第535回新潟医学会）},
 volume = {112},
 year = {1998}
}