{"id":8714,"date":"2025-10-29T12:18:18","date_gmt":"2025-10-29T17:18:18","guid":{"rendered":"https:\/\/ami.advancedrenaleducation.com\/wparep\/asiapacific\/?post_type=article&p=8714"},"modified":"2025-10-29T12:18:18","modified_gmt":"2025-10-29T17:18:18","slug":"%eb%8b%b9%eb%87%a8%eb%b3%91%ea%b3%bc-%eb%8b%b9%eb%87%a8%eb%b3%91%ec%bd%a9%ed%8c%a5%eb%b3%91","status":"publish","type":"article","link":"https:\/\/ami.advancedrenaleducation.com\/wparep\/asiapacific\/article\/%eb%8b%b9%eb%87%a8%eb%b3%91%ea%b3%bc-%eb%8b%b9%eb%87%a8%eb%b3%91%ec%bd%a9%ed%8c%a5%eb%b3%91\/","title":{"rendered":"\ub2f9\ub1e8\ubcd1\uacfc \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1"},"content":{"rendered":"

\ub2f9\ub1e8\ubcd1<\/strong><\/h3>\n

\ubcd1\uc778\uacfc \ubd84\ub958<\/strong><\/h4>\n

\ub2f9\ub1e8\ubcd1(Diabetes Mellitus, DM)\uc740 \ud754\ud788 ‘\ub2f9\ub1e8(Diabetes)’\ub77c\uace0 \ubd88\ub9ac\uba70, \uace0\ud608\ub2f9(hyperglycemia)\uc744 \ud2b9\uc9d5\uc73c\ub85c \ud558\ub294 \ub300\uc0ac \uc9c8\ud658\ub4e4\ub85c, \uc778\uc290\ub9b0 \ubd84\ube44\uc5d0 \ubb38\uc81c\uac00 \uc788\uac70\ub098 \uc778\uc290\ub9b0\uc774 \uc81c\ub300\ub85c \uc791\uc6a9\ud558\uc9c0 \ubabb\ud558\uac70\ub098, \ud639\uc740 \ub450 \uac00\uc9c0 \ubaa8\ub450\uc5d0 \ubb38\uc81c\uac00 \uc788\uc744 \ub54c \ubc1c\uc0dd\ud569\ub2c8\ub2e4(1-3). DM\uc740 \ub0b4\ubd84\ube44\uacc4\uc5d0\uc11c \uac00\uc7a5 \ud754\ud55c \uc9c8\ud658\uc73c\ub85c, 1\ud615, 2\ud615, \uadf8\ub9ac\uace0 \uc784\uc2e0\uc131 \ub2f9\ub1e8\ubcd1\uc73c\ub85c \ubd84\ub958\ub429\ub2c8\ub2e4. 1\ud615\ub2f9\ub1e8\ubcd1\uc740 \uc774\uc804\uc5d0 \uc18c\uc544\ub2f9\ub1e8 \ub610\ub294 \uc778\uc290\ub9b0 \uc758\uc874\uc131 \ub2f9\ub1e8\ubcd1\uc73c\ub85c \uc54c\ub824\uc84c\uc73c\uba70, \uc804\uccb4 \ub2f9\ub1e8 \ud658\uc790 \uc911 5-10%\ub97c \ucc28\uc9c0\ud569\ub2c8\ub2e4(1-3). 1\ud615\ub2f9\ub1e8\ubcd1\uc5d0\uc11c\ub294 \uc790\uac00\uba74\uc5ed \ubc18\uc751\uc73c\ub85c \ucdcc\uc7a5\uc758 \ubca0\ud0c0 \uc138\ud3ec\uac00 \ud30c\uad34\ub418\uc5b4 \uc2ec\uac01\ud55c \uc778\uc290\ub9b0 \uacb0\ud54d \ub610\ub294 \uc778\uc290\ub9b0\uc758 \uc0dd\uc131\ud558\uc9c0 \ubabb\ud569\ub2c8\ub2e4(1-3). 1\ud615\ub2f9\ub1e8\ubcd1 \ud658\uc790\ub294 \uc0dd\uc874\uc744 \uc704\ud574 \uc678\uc778\uc131 \uc778\uc290\ub9b0 \ub300\uccb4 \uc694\ubc95 \ubc0f\/\ub610\ub294 \ucdcc\uc7a5\uc774\ub098 \ucdcc\uc7a5 \uc12c\uc720\uc138\ud3ec\uc758 \uc774\uc2dd\uc774 \uc77c\ubc18\uc801\uc73c\ub85c \ud544\uc694\ud569\ub2c8\ub2e4. 1\ud615\ub2f9\ub1e8\ubcd1\uc740 \uc8fc\ub85c \uc18c\uc544\uc640 \uc80a\uc740 \uc131\uc778\uc5d0\uc11c \ubc1c\uc0dd\ud558\uc9c0\ub9cc, \ubaa8\ub4e0 \uc5f0\ub839\uc5d0\uc11c \ubc1c\ubcd1\ud560 \uc218 \uc788\uc2b5\ub2c8\ub2e4. 2\ud615\ub2f9\ub1e8\ubcd1\uc740 \uc774\uc804\uc5d0 \uc131\uc778\ubc1c\ubcd1 \ub610\ub294 \ube44\uc778\uc290\ub9b0 \uc758\uc874\uc131 \ub2f9\ub1e8\ub85c \uc54c\ub824\uc838 \uc788\uc73c\uba70, \ub2f9\ub1e8 \ud658\uc790 \uc911 90%~95%\ub97c \ucc28\uc9c0\ud569\ub2c8\ub2e4(1-3). 2\ud615\ub2f9\ub1e8\ubcd1\uc740 \uc778\uc290\ub9b0 \uc800\ud56d\uc131\uacfc \uc778\uc290\ub9b0 \uc218\uce58 \uc99d\uac00\uc640 \uad00\ub828\uc774 \uc788\uc2b5\ub2c8\ub2e4. \uc2dc\uac04\uc774 \uc9c0\ub0a8\uc5d0 \ub530\ub77c \ucdcc\uc7a5\uc758 \uc778\uc290\ub9b0 \ubd84\ube44\uac00 \uc810\uc9c4\uc73c\ub85c \uac10\uc18c\ud558\ub294 \uacbd\ud5a5\uc774 \uc885\uc885 \uad00\ucc30\ub418\uba70, \uc774\ub85c \uc778\ud574 \ud6c4\uae30 \ub2e8\uacc4\uc5d0\uc11c\ub294 \uace0\uc778\uc290\ub9b0\ud608\uc99d\uc774 \uac10\uc18c\ud569\ub2c8\ub2e4(1-3). 2\ud615 \ub2f9\ub1e8\ubcd1\uc758 \uad00\ub9ac\ub294 \uc0dd\ud65c \uc2b5\uad00 \ubcc0\ud654\uc640 \uc57d\ubb3c \uc694\ubc95\uc758 \uc870\ud569\uc5d0 \uc911\uc810\uc744 \ub461\ub2c8\ub2e4. 2\ud615\ub2f9\ub1e8\ubcd1\uc758 \uc704\ud5d8 \uc99d\uac00\ub294 \uace0\ub839, \ube44\ub9cc, \uac00\uc871\ub825, \uc2e0\uccb4 \ud65c\ub3d9 \ubd80\uc871, \ud2b9\uc815 \uc778\uc885 \ubc0f \uae30\ud0c0 \ub2e4\uc591\ud55c \uc694\uc778\uc774 \uc788\uc2b5\ub2c8\ub2e4(1-3). \uc784\uc2e0\ub2f9\ub1e8\ubcd1\uc740 \uc784\uc2e0 \uc911\uc5d0 \uc0dd\uc0b0\ub418\ub294 \uc778\uc290\ub9b0 \uc800\ud574 \ud638\ub974\ubaac(insulin-interfering hormones)\uc5d0 \uc758\ud574 \ubc1c\uc0dd\ud558\ub294 \uac83\uc73c\ub85c \uc5ec\uaca8\uc9d1\ub2c8\ub2e4. \uc784\uc2e0\ub2f9\ub1e8\ubcd1\uc740 \uc77c\ubc18\uc801\uc73c\ub85c \ucd9c\uc0b0 \ud6c4\uc5d0 \uc0ac\ub77c\uc9c0\uc9c0\ub9cc, \uc784\uc2e0\ub2f9\ub1e8\ubcd1 \ubcd1\ub825\uc774 \uc788\ub294 \uc5ec\uc131\uc740 5-10\ub144 \ub0b4\uc5d0 2\ud615\ub2f9\ub1e8\ubcd1 \ubc1c\ubcd1 \uc704\ud5d8\uc774 40%\uc5d0\uc11c 60%\uc5d0 \uc774\ub985\ub2c8\ub2e4(1-3).<\/p>\n

\uc720\ubcd1\ub960:<\/strong><\/h4>\n

2019\ub144\uc5d0\ub294 \uc804 \uc138\uacc4\uc801\uc73c\ub85c 4\uc5b5 6,300\ub9cc \uba85\uc774 \ub2f9\ub1e8\ubcd1\uc744 \uc553\uace0 \uc788\ub294 \uac83\uc73c\ub85c \ucd94\uc815\ub418\uc5c8\uc73c\uba70 2045\ub144\uae4c\uc9c0 \uc720\ubcd1\ub960\uc774 7\uc5b5 \uba85\uc73c\ub85c \uc99d\uac00\ud560 \uac83\uc73c\ub85c \uc608\uc0c1\ub429\ub2c8\ub2e4(4). \ub9c8\ucc2c\uac00\uc9c0\ub85c \ubbf8\uad6d\uc5d0\uc11c\ub3c4 \uc9c0\ub09c 30\ub144 \ub3d9\uc548 \ub2f9\ub1e8\ubcd1 \uc720\ubcd1\ub960\uc774 \uc99d\uac00\ud574\uc654\uc2b5\ub2c8\ub2e4. 2018\ub144 \ubbf8\uad6d\uc9c8\ubcd1\ud1b5\uc81c\uc608\ubc29\uc13c\ud130(CDC)\uc758 ‘\uad6d\uac00 \ub2f9\ub1e8\ubcd1 \ud1b5\uacc4 \uc790\ub8cc\uc9d1’\uc5d0 \ub530\ub974\uba74 18\uc138 \uc774\uc0c1 \uc131\uc778 3,410\ub9cc \uba85, \uc989 \ubbf8\uad6d \uc131\uc778\uc758 13.0%\uac00 \ub2f9\ub1e8\ubcd1\uc744 \uac16\uace0 \uc788\uc5c8\uc73c\uba70, \uc774 \uc911 700\ub9cc \uba85 \uc774\uc0c1(\ubbf8\uad6d \uc804\uccb4 \uc131\uc778\uc758 2.8%)\uc774 \ub2f9\ub1e8\ubcd1\uc744 \uc9c4\ub2e8\ubc1b\uc9c0 \uc54a\uc740 \uac83\uc73c\ub85c \ucd94\uc815\ub429\ub2c8\ub2e4. \ub610\ud55c 2018\ub144 \uc57d 8,800\ub9cc \uba85\uc774 \uacf5\ubcf5 \ud608\ub2f9 \ub610\ub294 HbA1c \uc218\uce58\ub97c \uae30\uc900\uc73c\ub85c \ub2f9\ub1e8\ubcd1 \uc804 \ub2e8\uacc4 \uc0c1\ud0dc\uc778 \uac83\uc73c\ub85c \ucd94\uc815\ub429\ub2c8\ub2e4(2). 1999-2016\ub144 \uc0ac\uc774 \ucd1d \ub2f9\ub1e8\ubcd1\uc758 \uc5f0\ub839 \ud45c\uc900\ud654 \uc720\ubcd1\ub960\uc740 18\uc138 \uc774\uc0c1 \uc131\uc778\uc5d0\uc11c \uc720\uc758\ud558\uac8c \uc99d\uac00\ud588\uc2b5\ub2c8\ub2e4(\uadf8\ub9bc 1). 2018\ub144 18\uc138 \uc774\uc0c1 \ubbf8\uad6d \uc131\uc778\uc758 \ub2f9\ub1e8\ubcd1 \uc2e0\uaddc \ubc1c\ubcd1 \ucd94\uc815\uce58\ub294 150\ub9cc \uba85\uc73c\ub85c 1,000\uba85\ub2f9 6.9\uba85\uc774\uc5c8\uc2b5\ub2c8\ub2e4. 18\uc138\uc5d0\uc11c 44\uc138 \uc0ac\uc774\uc758 \uc131\uc778\uacfc \ube44\uad50\ud588\uc744 \ub54c, \uc9c4\ub2e8\ubc1b\uc740 \ub2f9\ub1e8\ubcd1 \ubc1c\ubcd1\ub960\uc740 45\uc138\uc5d0\uc11c 64\uc138 \uc0ac\uc774\uc758 \uc131\uc778\uacfc 65\uc138 \uc774\uc0c1\uc758 \uc131\uc778\uc5d0\uc11c \ub354 \ub192\uc558\uc2b5\ub2c8\ub2e4. <\/span><\/span>\u00a0<\/span><\/p>\n

 <\/p>\n

\uadf8\ub9bc 1: 18\uc138 \uc774\uc0c1 \uc131\uc778\uc758 \uc9c4\ub2e8\ub41c \ub2f9\ub1e8\ubcd1 \ubc1c\ubcd1\ub960 \ubc0f \uc720\ubcd1\ub960 \ucd94\uc774, \ubbf8\uad6d, 1980\u20132015\ub144 (5). \ucc38\uace0: \uc9c4\ub2e8\ub41c \ub2f9\ub1e8\ubcd1(Diagnosed diabetes)\uc740 \uc790\uac00 \ubcf4\uace0\ub97c \uae30\ubc18\uc73c\ub85c \ud569\ub2c8\ub2e4. \uc9c4\ub2e8\ub418\uc9c0 \uc54a\uc740 \ub2f9\ub1e8\ubcd1(Undiagnosed diabetes)\uc740 \ub2f9\ub1e8\ubcd1\uc774 \uc5c6\ub2e4\uace0 \uc2a4\uc2a4\ub85c \ubcf4\uace0\ud55c \uc0ac\ub78c\ub4e4\uc758 \uacf5\ubcf5 \ud608\ub2f9 \ubc0f A1C \uc218\uce58\ub97c \uae30\ubc18\uc73c\ub85c \ud569\ub2c8\ub2e4.<\/p>\n

\"\"<\/p>\n

\uadf8\ub9bc 2. 18\uc138 \uc774\uc0c1 \uc131\uc778\uc758 \uc9c4\ub2e8\ub41c \ub2f9\ub1e8\ubcd1, \uc9c4\ub2e8\ub418\uc9c0 \uc54a\uc740 \ub2f9\ub1e8\ubcd1 \ubc0f \ucd1d \ub2f9\ub1e8\ubcd1\uc758 \uc5f0\ub839 \ud45c\uc900\ud654(age-adjusted) \uc720\ubcd1\ub960 \ucd94\uc774, \ubbf8\uad6d, 1999\u20132016\ub144(2). <\/span><\/p>\n

\"\"<\/p>\n

2019\ub144 \uc804 \uc138\uacc4 \uc5ec\uc131\uc758 \ub2f9\ub1e8\ubcd1 \uc720\ubcd1\ub960\uc740 \uc57d 9.0%, \ub0a8\uc131\uc758 \uacbd\uc6b0 9.6%\ub85c \ucd94\uc815\ub418\uc5c8\uc2b5\ub2c8\ub2e4(\uadf8\ub9bc 3). <\/span><\/p>\n

 <\/p>\n

\uadf8\ub9bc 3: 2019\ub144 \uc804 \uc138\uacc4 \uc5f0\ub839 \ubc0f \uc131\ubcc4\uc5d0 \ub530\ub978 \ub2f9\ub1e8\ubcd1 \uc720\ubcd1\ub960(4). <\/span><\/p>\n

\"\"<\/p>\n

 <\/p>\n

\uc774\ub7ec\ud55c \ub2f9\ub1e8\ubcd1\uc758 \uc720\ubcd1\ub960 \uc99d\uac00\ub294 \uc77c\ubc18 \uc778\uad6c\uc758 \uae30\ub300 \uc218\uba85 \uc5f0\uc7a5, \ud5a5\uc0c1\ub41c \uc9c4\ub2e8 \uae30\uc220 \ubc0f \uae30\uc900(6), \uadf8\ub9ac\uace0 \ube44\ub9cc \ubc0f \ub300\uc0ac \uc99d\ud6c4\uad70\uc758 \uc99d\uac00\uc5d0 \uae30\uc778\ud560 \uc218 \uc788\uc2b5\ub2c8\ub2e4(7,8). 2016\ub144 \uae30\uc900\uc73c\ub85c \uc804\uad6d\uc801\uc73c\ub85c 4,100\uac1c \uc774\uc0c1\uc758 \ub2f9\ub1e8\ubcd1 \uc790\uac00 \uad00\ub9ac \uad50\uc721 \ubc0f \uc9c0\uc6d0(DSMES) \ud504\ub85c\uadf8\ub7a8(\uc57d 110\ub9cc \uba85)\uc774 \uc81c\uacf5\ub418\uc5c8\uc2b5\ub2c8\ub2e4(2,5). <\/span><\/p>\n

\uc9c0\ub09c 30\ub144 \ub3d9\uc548 2\ud615\ub2f9\ub1e8\ubcd1 \uc18c\uc544\uc758 \ubc1c\ubcd1\ub960\ub3c4 \uc99d\uac00\ud558\uace0 \uc788\uc73c\uba70, \uc774\ub294 \uc18c\uc544 \ube44\ub9cc\ub960\uc758 \uc0c1\uc2b9\uacfc \uc720\uc0ac\ud55c \uc591\uc0c1\uc744 \ubcf4\uc774\uace0 \uc788\uc2b5\ub2c8\ub2e4(9,10). \ub2f9\ub1e8\ubcd1 \uc9c4\ub2e8\uc744 \ubc1b\uc740 \uc57d 3,420\ub9cc \uba85 \uac00\uc6b4\ub370 20\uc138 \ubbf8\ub9cc\uc778 \uc18c\uc544 \ubc0f \uccad\uc18c\ub144\uc740 21\ub9cc \uba85\uc73c\ub85c \ucd94\uc815\ub418\uba70, \uc774\ub294 \ud574\ub2f9 \uc778\uad6c\uc758 \uc57d 0.25%\ub97c \ucc28\uc9c0\ud569\ub2c8\ub2e4(2,5). SEARCH for Diabetes in Youth \uc5f0\uad6c\uc5d0\uc11c \uc5bb\uc740 \ub370\uc774\ud130\uc5d0 \ub530\ub974\uba74, 2014-2015\ub144 \uc0ac\uc774\uc5d0 \uccad\uc18c\ub144\uce35\uc758 \uc9c4\ub2e8\ub41c \ub2f9\ub1e8\ubcd1 \uc5f0\uac04 \ubc1c\ubcd1\ub960\uc740 1\ud615 \ub2f9\ub1e8\ubcd1 \uc57d 18,200\uba85, 2\ud615 \ub2f9\ub1e8\ubcd1 \uc57d 5,800\uba85 \uac19\uc774 \ucd94\uc815\ub418\uc5c8\uc2b5\ub2c8\ub2e4(2). \ubbf8\uad6d\uc758 NHANES(National Health and Nutrition Examination Surveys)\uc5d0 \ub530\ub974\uba74, 2015-2016\ub144 2\uc138\ubd80\ud130 19\uc138\uae4c\uc9c0\uc758 \uccad\uc18c\ub144\uce35\uc758 \ube44\ub9cc \uc720\ubcd1\ub960\uc740 18.5%\ub85c \ub098\ud0c0\ub0ac\uc2b5\ub2c8\ub2e4. 1999-2000\ub144\ubd80\ud130 2015-2016\ub144\uae4c\uc9c0 \uc131\uc778\uacfc \uccad\uc18c\ub144 \ubaa8\ub450\uc5d0\uc11c \ube44\ub9cc\uc758 \uc99d\uac00 \ucd94\uc138\uac00 \ub69c\ub837\ud558\uac8c \ub098\ud0c0\ub0ac\uc2b5\ub2c8\ub2e4. \uadf8\ub7ec\ub098 2013-2014\ub144\uacfc 2015-2016\ub144 \uc0ac\uc774\uc758 \uc720\ubcd1\ub960 \ubcc0\ud654\ub294 \uc131\uc778\uc774\ub098 \uccad\uc18c\ub144 \uc5b4\ub290 \ucabd\uc5d0\uc11c\ub3c4 \uc720\uc758\ubbf8\ud558\uc9c0 \uc54a\uc558\uc2b5\ub2c8\ub2e4. \uc804\ubc18\uc801\uc73c\ub85c \uccad\uc18c\ub144(12-19\uc138, 20.6%)\uacfc \ud559\ub839\uae30(6-11\uc138, 18.4%)\uc758 \ube44\ub9cc \uc720\ubcd1\ub960\uc740 \ubbf8\ucde8\ud559 \uc544\ub3d9(2-5\uc138, 13.9%)\ubcf4\ub2e4 \ub192\uc558\ub2e4(11). \uc5f0\uad6c\uc5d0 \ub530\ub974\uba74 \ube44\ub9cc\uacfc \ub2f9\ub1e8\ubcd1 \uc0ac\uc774\uc5d0 \uac15\ud55c \uc0c1\uad00\uad00\uacc4\uac00 \uc788\uc73c\uba70, \ud2b9\ud788 \ube44\ub9cc \uc544\ub3d9\uc758 25%\uac00 \ud3ec\ub3c4\ub2f9 \ub0b4\uc131\uc774 \uc800\ud558\ub418\uc5b4 \uc788\uc73c\uba70, \ube44\ub9cc \uc544\ub3d9 \uc911 1-2%\ub294 2\ud615\ub2f9\ub1e8\ubcd1\uc744 \uc553\uac8c \ub429\ub2c8\ub2e4. \ub530\ub77c\uc11c \uc18c\uc544 \uc778\uad6c\uc5d0\uc11c \ub2f9\ub1e8\ubcd1\uc758 \uc2e0\uaddc \ubc1c\ubcd1 \uc0ac\ub840 \uc911 \uc57d 45%\uac00 2\ud615\ub2f9\ub1e8\ubcd1\uc5d0 \ud574\ub2f9\ud558\uba70, \ud604\uc7ac \ubbf8\uad6d\uc5d0\uc11c 20\uc138 \ubbf8\ub9cc\uc758 \uccad\uc18c\ub144 2\ubc31\ub9cc \uba85\uc774 \ud3ec\ub3c4\ub2f9 \ub0b4\uc131\uc744 \uac00\uc9c0\uace0 \uc788\ub2e4\ub294 \uac83\uc740 \ub180\ub77c\uc6b4 \uc77c\uc774 \uc544\ub2d9\ub2c8\ub2e4(5). <\/span><\/p>\n

2015\ub144, \ub2f9\ub1e8\ubcd1\uc740 \ubbf8\uad6d\uc5d0\uc11c \uc77c\uacf1 \ubc88\uc9f8 \uc8fc\uc694\ud55c \uc0ac\ub9dd \uc6d0\uc778\uc774\uc5c8\uc2b5\ub2c8\ub2e4(5). \ub2f9\ub1e8\ubcd1 \ud658\uc790\uc758 \uc804\ubc18\uc801\uc778 \uc0ac\ub9dd \uc704\ud5d8\uc740 \ub2f9\ub1e8\ubcd1\uc774 \uc5c6\ub294 \uc0ac\ub78c\uc758 \uac70\uc758 \ub450 \ubc30\uc785\ub2c8\ub2e4(5). \ub2f9\ub1e8\ubcd1\uc131 \ud569\ubcd1\uc99d\uc740 \ub300\ud608\uad00 (\uc608: \uad00\uc0c1\ub3d9\ub9e5 \uc9c8\ud658 \ubc0f \ub9d0\ucd08 \ud608\uad00 \uc9c8\ud658)\uacfc \ubbf8\uc138\ud608\uad00 (\uc608: \ub9dd\ub9c9\ubcd1\uc99d, \uc2e0\uc7a5\ubcd1\uc99d \ubc0f \uc2e0\uacbd\ubcd1\uc99d) \ubaa8\ub450\uc5d0 \uc601\ud5a5\uc744 \ubbf8\uce58\uba70(3), \uc774\ub294 \uc0ac\ub9dd\ub960\uc5d0 \uc0c1\ub2f9\ud55c \uc601\ud5a5\uc744 \uc90d\ub2c8\ub2e4. 2016\ub144, \ubbf8\uad6d 18\uc138 \uc774\uc0c1 \uc131\uc778 \uc911 \ub2f9\ub1e8\ubcd1\uc774 \uc9c4\ub2e8\ub41c \uc0c1\ud0dc\ub85c \ud1f4\uc6d0\ud55c \ubcd1\uc6d0 \ud658\uc790\uac00 \ucd1d 780\ub9cc \uba85(\ub2f9\ub1e8\ubcd1 \ud658\uc790 1,000\uba85\ub2f9 339.0\uba85)\uc73c\ub85c \ubcf4\uace0\ub418\uc5c8\uc2b5\ub2c8\ub2e4. \uc774 \uc911\uc5d0\ub294 \uc8fc\uc694 \uc2ec\ud608\uad00 \uc9c8\ud658\uc73c\ub85c \uc778\ud55c 170\ub9cc \uba85 (\ub2f9\ub1e8\ubcd1 \ud658\uc790 1,000\uba85\ub2f9 75.3 \uba85) \ubc0f \ub2f9\ub1e8\ubcd1\ucf00\ud1a4\uc0b0\uc99d 16.8\ub9cc \uac74\uc774 \ud3ec\ud568\ub418\uc5c8\uc2b5\ub2c8\ub2e4(5). \uac8c\ub2e4\uac00, \ub2f9\ub1e8\ub294 13\ub9cc \uac74\uc758 \uc808\ub2e8 \uc218\uc220(5), 11.7%\uc758 \uc0c8\ub86d\uac8c \ubc1c\uc0dd\ud55c \uc2e4\uba85blindness) \uc0ac\ub840(2), \uadf8\ub9ac\uace0 \ub9e4\ub144 50\ub9cc \uac74 \uc774\uc0c1\uc758 \uc785\uc6d0 \uce58\ub8cc\ub97c \uc720\ubc1c\ud558\uace0 \uc788\uc2b5\ub2c8\ub2e4. <\/span><\/p>\n

\uc774\ub7ec\ud55c \ud569\ubcd1\uc99d\uc73c\ub85c \uc778\ud574 \ub2f9\ub1e8\ubcd1\uc740 2017\ub144 \uc5f0\uac04 3,270\uc5b5 \ub2ec\ub7ec (\uc9c1\uc811 \uc758\ub8cc\ube44 2,370\uc5b5 \ub2ec\ub7ec, \uac04\uc811 \uc758\ub8cc\ube44 900\uc5b5 \ub2ec\ub7ec \ud3ec\ud568)\uc5d0 \ub2ec\ud558\ub294 \uace0\uac00\uc758 \uc9c8\ubcd1\uc774 \ub418\uc5c8\uc2b5\ub2c8\ub2e4. \ub610\ud55c \uc758\ub8cc \ube44\uc6a9 10\ub2ec\ub7ec \uc911 1\ub2ec\ub7ec\uac00 \ub2f9\ub1e8\ubcd1 \ub610\ub294 \uadf8 \ud569\ubcd1\uc99d\uc73c\ub85c \uc778\ud574 \uc9c0\ucd9c\ub418\ub294 \uac83\uc73c\ub85c \ucd94\uc815\ub429\ub2c8\ub2e4. 2017\ub144 \ub2f9\ub1e8\ubcd1\uc740 \ubbf8\uad6d\uc5d0\uc11c \uc77c\uacf1 \ubc88\uc9f8 \uc8fc\uc694 \uc0ac\ub9dd \uc6d0\uc778\uc774\uc5c8\uc2b5\ub2c8\ub2e4. \uc774 \uacb0\uacfc\ub294 \ub2f9\ub1e8\ubcd1\uc774 \uc8fc\uc694 \uc0ac\ub9dd \uc6d0\uc778\uc73c\ub85c \uba85\uc2dc\ub41c 83,564\uba85\uc758 \uc0ac\ub9dd\uc99d\uba85\uc11c\ub97c \uae30\ubc18\uc73c\ub85c \ud558\uc600\uc2b5\ub2c8\ub2e4 (\uc778\uad6c 10\ub9cc \uba85\ub2f9 25.7\uba85\uc758 \ube44\uc728\ub85c \ubc1c\uc0dd)(2). <\/span><\/p>\n

\uc120\ubcc4\uac80\uc0ac \ubc0f \uc9c4\ub2e8:<\/strong><\/p>\n

2018\ub144 \ubbf8\uad6d\ub2f9\ub1e8\ubcd1\ud559\ud68c(ADA)\ub294 \uacfc\uccb4\uc911 \ub610\ub294 \ube44\ub9cc\uc778 \ubaa8\ub4e0 \uc131\uc778\uc5d0\uac8c (BMI \u226525 kg\/m2 \ub610\ub294 \u226523 kg\/m2), \uadf8\ub9ac\uace0 \uc544\ub798\uc5d0\uc11c \ud558\ub098 \uc774\uc0c1\uc758 \ucd94\uac00\uc801\uc778 \uc704\ud5d8 \uc694\uc778\uc774 \uc788\ub294 \uacbd\uc6b0 \ub2f9\ub1e8\ubcd1 \uac80\uc0ac\ub97c \uad8c\uace0\ud558\uc600\uc2b5\ub2c8\ub2e4(12):<\/p>\n

    \n
  • \uc2e0\uccb4 \ud65c\ub3d9 \ubd80\uc871 <\/span><\/li>\n
  • \ub2f9\ub1e8\ubcd1 \uac00\uc871\ub825 <\/span><\/li>\n
  • \uace0\uc704\ud5d8 \uc778\uc885 \uc9d1\ub2e8 \uad6c\uc131\uc6d0 (\uc608: \uc544\ud504\ub9ac\uce74\uacc4 \ubbf8\uad6d\uc778, \ub77c\ud2f4\uacc4, \uc544\uba54\ub9ac\uce74 \uc6d0\uc8fc\ubbfc, \uc544\uc2dc\uc544\uc778 \ub610\ub294 \ud0dc\ud3c9\uc591 \uc12c \uc8fc\ubbfc) <\/span><\/li>\n
  • \uace0\ud608\uc555 (\u2265140\/90 mmHg) <\/span><\/li>\n
  • HDL <35 mg\/dl \ub610\ub294 \uc911\uc131\uc9c0\ubc29 >250 mg\/dl
    \n<\/span><\/li>\n
  • \uc2ec\ud608\uad00 \uc9c8\ud658\uc758 \ubcd1\ub825<\/li>\n
  • 45\uc138 \uc774\uc0c1 <\/span><\/li>\n
  • \ub2e4\ub0ad\uc131 \ub09c\uc18c \uc99d\ud6c4\uad70\uc744 \uac00\uc9c4 \uc5ec\uc131 <\/span><\/li>\n<\/ul>\n

    \uac80\uc0ac \uc694\uac74\uc774 \ucda9\uc871\ub418\uba74, \ub2e4\uc74c \uc911 \ud558\ub098\uc5d0 \ud574\ub2f9\ud558\ub294 \uacbd\uc6b0 \ub2f9\ub1e8\ubcd1 \uc9c4\ub2e8\uc744 \ub0b4\ub9b4 \uc218 \uc788\uc2b5\ub2c8\ub2e4(13,14): <\/span><\/p>\n

      \n
    • \ub2f9\ud654\ud608\uc0c9\uc18c 6.5% \uc774\uc0c1 <\/span><\/li>\n
    • \uacf5\ubcf5 \ud608\ub2f9 126 mg\/dL \uc774\uc0c1 <\/span><\/li>\n
    • \uacbd\uad6c \ud3ec\ub3c4\ub2f9 \ub0b4\uc131 \uac80\uc0ac(OGTT) \uc911 2\uc2dc\uac04 \ud608\uc7a5 \ud3ec\ub3c4\ub2f9 \u2265 200mg\/dl <\/span><\/li>\n
    • \uace0\ud608\ub2f9\uc758 \uc804\ud615\uc801\uc778 \uc99d\uc0c1 \ubc0f \ubb34\uc791\uc704 \ud608\ub2f9 200 mg\/dl \uc774\uc0c1 <\/span><\/li>\n<\/ul>\n

      \ub300\ubd80\ubd84\uc758 \uacbd\uc6b0, \uc9c4\ub2e8\uc774 \uc784\uc0c1\uc801\uc73c\ub85c \uba85\ud655\ud558\uc9c0 \uc54a\ub2e4\uba74 \uc7a0\uc7ac\uc801\uc778 \uac80\uc0ac \uc624\ub958\ubc30\uc81c \uc704\ud55c \ubc18\ubcf5 \uac80\uc0ac\ub97c \ud1b5\ud574 \uc9c4\ub2e8\uc744 \ud655\uc778\ud574\uc57c \ud569\ub2c8\ub2e4. (13,14): <\/span><\/p>\n

      \uacbd\uc6b0\uc5d0 \ub530\ub77c, \ud608\ub2f9 \uc218\uce58\uac00 \uc815\uc0c1 \ubc94\uc704 \ucd08\uacfc\ud558\uc9c0\ub9cc \ub2f9\ub1e8\ubcd1 \uc9c4\ub2e8 \uae30\uc900\uc5d0\ub294 \ubbf8\uce58\uc9c0 \ubabb\ud558\ub294 \ud658\uc790\uc5d0\uac8c “\ub2f9\ub1e8\ubcd1\uc804\ub2e8\uacc4(prediabetes)” \uc9c4\ub2e8\uc744 \ub0b4\ub9b4 \uc218 \uc788\uc2b5\ub2c8\ub2e4. \uc774\ub294 \ud658\uc790\uac00 \ub2f9\ub1e8\ubcd1\uc744 \uac16\uace0 \uc788\ub2e4\ub294 \uac83\uc744 \uc758\ubbf8\ud558\uc9c0 \uc54a\uc9c0\ub9cc, \ub2f9\ub1e8\ubcd1 \ubc0f \uc2ec\ud608\uad00 \uc9c8\ud658 \uc704\ud5d8\uc774 \uc99d\uac00\ud588\uc74c\uc744 \ub098\ud0c0\ub0c5\ub2c8\ub2e4.<\/span><\/p>\n

      \ub2f9\ub1e8\ubcd1\uc804\ub2e8\uacc4\uc758 \uc9c4\ub2e8\uc740 \ub2e4\uc74c\uacfc \uac19\uc740 \uacb0\uacfc\ub97c \ubcf4\uc774\ub294 \uac1c\uc778\uc5d0\uac8c \ub0b4\ub824\uc9c8 \uc218 \uc788\uc2b5\ub2c8\ub2e4:<\/p>\n

        \n
      • \ub2f9\ud654\ud608\uc0c9\uc18c 5.7-6.4%\u00a0\uc0ac\uc774\uc778 \uacbd\uc6b0 <\/span><\/li>\n
      • \uacf5\ubcf5 \ud608\ub2f9\uc774 100 – 125 mg\/dl \uc0ac\uc774\uc778 \uacbd\uc6b0 <\/span><\/li>\n
      • 2\uc2dc\uac04 \uacbd\uacfc \ud6c4 \ud608\ub2f9\uc774 140 – 199 mg\/dl \uc0ac\uc774\uc778 \uacbd\uc6b0 <\/span>\u00a0<\/span><\/li>\n<\/ul>\n

        \ub2f9\ub1e8\ubcd1\uc804\ub2e8\uacc4\uc640 \ub2f9\ub1e8\ubcd1\uc758 \uc9c4\ub2e8 \ubc0f \uce58\ub8cc\uc5d0 \ub300\ud55c \ub354 \ub9ce\uc740 \uc815\ubcf4\ub294 \ubbf8\uad6d\ub2f9\ub1e8\ubcd1\ud559\ud68c \uc6f9\uc0ac\uc774\ud2b8(professional.diabetes.org)\uc5d0\uc11c \ud655\uc778\ud558\uc2e4 \uc218 \uc788\uc2b5\ub2c8\ub2e4.<\/p>\n

         <\/p>\n

        \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1 (\ub2f9\ub1e8\ubcd1\uc2e0\uc7a5\ubcd1\uc99d)<\/strong> <\/span><\/p>\n

        \uc720\ubcd1\ub960 \ubc0f \uc120\ubcc4 \uac80\uc0ac:<\/strong><\/p>\n

        \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1(DKD), \ub610\ub294 \ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d(DN)\uc740 \ub2f9\ub1e8\ubcd1\uc5d0 \uc758\ud574 \uc720\ubc1c\ub41c \uc2e0\uc7a5\uc758 \ubbf8\uc138\ud608\uad00 \ud569\ubcd1\uc99d\uc73c\ub85c \uc815\uc758\ub418\uba70, \ub2e4\ub978 \uc2e0\uc7a5\uc9c8\ud658 \uc5c6\uc774 \uc54c\ubd80\ubbfc\ub1e8\uc640 \ucf69\ud325 \uae30\ub2a5\uc758 \uc810\uc9c4\uc801\uc778 \uc0c1\uc2e4\uc744 \ud2b9\uc9d5\uc73c\ub85c \ud569\ub2c8\ub2e4(15). \ub2f9\ub1e8\ubcd1\uc740 \uc804 \uc138\uacc4\uc801\uc73c\ub85c \ub9cc\uc131\ucf69\ud325\ubcd1\uc758 \uc8fc\uc694 \uc6d0\uc778\uc73c\ub85c, \ubbf8\uad6d\uc5d0\uc11c\ub294 \uc57d 35-50%\uc758 \uc0ac\ub840\ub97c \ucc28\uc9c0\ud569\ub2c8\ub2e4(16). DKD\ub294 1\ud615\ub2f9\ub1e8\ubcd1 \ud658\uc790\uc758 \uc57d 30%\uc640 2\ud615\ub2f9\ub1e8\ubcd1 \ud658\uc790\uc758 40%\uc5d0\uc11c \ubc1c\uc0dd\ud558\uba70, \ub9d0\uae30\uc2e0\uc7a5\ubcd1\uc758 \ub2e8\uc77c \uc8fc\uc694 \uc6d0\uc778\uc785\ub2c8\ub2e4 (\uadf8\ub9bc 4)(17). <\/span><\/p>\n

         <\/p>\n

        \uadf8\ub9bc 4. *\uc870\uc815\ub41c ESRD \ubc1c\ubcd1\ub960(\ubc31\ub9cc\uba85\/\ub144\ub2f9)\uc758 \ucd94\uc774. ESRD \uc8fc\uc694 \uc6d0\uc778\uc5d0 \ub530\ub984, \ubbf8\uad6d \uc778\uad6c,1996-2014. *\uc5f0\ub839, \uc131\ubcc4 \ubc0f \uc778\uc885\uc5d0 \ub530\ub77c \uc870\uc815. \ud45c\uc900 \uc778\uad6c\ub294 2011\ub144 \ubbf8\uad6d \uc778\uad6c. \uc57d\uc5b4: ESRD(end-stage renal disease, \ub9d0\uae30\ucf69\ud325\ubcd1). <\/span><\/p>\n

        \"\"<\/p>\n

         <\/p>\n

        \uadf8\ub7ec\ub098 \ubbf8\uad6d\uc2e0\uc7a5\ud658\uc790\ub4f1\ub85d\uc2dc\uc2a4\ud15c(USRDS)\uc758 \ucd5c\uc2e0 \ubcf4\uace0\uc11c(18)\uc5d0 \ub530\ub974\uba74, \ub2f9\ub1e8\ubcd1\uc744 ESRD\uc758 \uc8fc\uc694 \uc6d0\uc778\uc73c\ub85c \ub098\ud0c0\ub0b4\ub294 CMS(Centers for Medicare and Medicaid Services) 2728\uc758 \ub370\uc774\ud130\ub294 ESRD \ud658\uc790 \uc911 \ub2f9\ub1e8\ubcd1\uc744 \uac00\uc9c0\uace0 \uc788\uc9c0\ub9cc, \ub2f9\ub1e8\ubcd1\uc774 ESRD\uc758 \uc8fc\uc694 \uc6d0\uc778\uc774 \uc544\ub2cc \ud658\uc790\ub4e4\uc744 \ub098\ud0c0\ub0bc \uc218 \uc788\ub2e4\uace0 \uc81c\uc548\ud558\uace0 \uc788\uc2b5\ub2c8\ub2e4. \uc774\ub294 \uc0dd\uac80\uc73c\ub85c \ud655\uc778\ub41c \ub2f9\ub1e8\ubcd1 \uc2e0\uc7a5\ubcd1\uc99d\uc5d0 \ub300\ud55c \ubcf4\uace0\uc640 \uc720\uc0ac\ud558\uc9c0\ub9cc, \uc0dd\uac80\uc744 \ubc1b\ub294 \ud658\uc790\uc5d0\uc11c \uc120\ud0dd \ud3b8\ud5a5\uc774 \uc788\uc744 \uac00\ub2a5\uc131\uc774 \uc788\uc2b5\ub2c8\ub2e4(19). \ub610\ud55c, \uc815\ud655\uc131\uc744 \uac1c\uc120\ud558\uace0 \uacfc\ud559\uc801 \ubc1c\uc804\uc5d0 \ubc1c\ub9de\ucd94\uae30 \uc704\ud574 CMS 2728 \uc591\uc2dd\uc5d0 \ub098\uc5f4\ub41c ESRD\uc758 \uc6d0\uc778 \ubd84\ub958\ub97c \uc7ac\uc870\uc815\ud560 \ud544\uc694\uac00 \uc788\uc744 \uc218 \uc788\uc2b5\ub2c8\ub2e4(20). <\/span>\u00a0<\/span><\/p>\n

        DKD\uc758 \uc120\ubcc4 \uac80\uc0ac\ub294 \uc54c\ubd80\ubbfc\ub1e8 \uce21\uc815\uc744 \ud1b5\ud574 \uc774\ub8e8\uc5b4\uc9c0\uba70, \uc5f0\uad6c\uc5d0\uc11c \ub2e8\ubc31\ub1e8\uac00 \ucf69\ud325 \uc190\uc0c1 \ubc0f \ud658\uc790 \uc0dd\uc874\uc758 \uac15\ub825\ud55c \uc608\uce21 \uc9c0\ud45c\uc784\uc744 \ubcf4\uc5ec\uc8fc\uace0 \uc788\uc2b5\ub2c8\ub2e4(21\u201323). <\/span><\/p>\n

        \ubbf8\uad6d\ub2f9\ub1e8\ubcd1\ud559\ud68c(ADA)\uc758 \uac00\uc774\ub4dc\ub77c\uc778\uc740 1\ud615\ub2f9\ub1e8\ubcd1\uc774 5\ub144 \uc774\uc0c1 \uc9c0\uc18d\ub41c \ud658\uc790, 2\ud615\ub2f9\ub1e8\ubcd1 \ud658\uc790, \uadf8\ub9ac\uace0 \uace0\ud608\uc555\uc774 \ub3d9\ubc18\ub41c \ubaa8\ub4e0 \ud658\uc790\uc5d0 \ub300\ud574 \uc801\uc5b4\ub3c4 1\ub144\uc5d0 \ud55c \ubc88 \uc774\uc0c1\uc758 \uc8fc\uae30\ub85c \uc54c\ubd80\ubbfc\ub1e8(\uc608: \ud608\ub1e8 \uc54c\ubd80\ubbfc-\ud06c\ub808\uc544\ud2f0\ub2cc \ube44\uc728)\uc640 \ucd94\uc815\uc0ac\uad6c\uccb4\uc5ec\uacfc\uc728\uc744 \ud3c9\uac00\ud558\ub3c4\ub85d \uad8c\uc7a5\ud558\uace0 \uc788\uc2b5\ub2c8\ub2e4(24). \uace0\uc704\ud5d8\uad70\uc744 \ub300\uc0c1\uc73c\ub85c \ud55c \ubb34\ub8cc \uac80\uc0ac\ub294 \ubbf8\uad6d \uad6d\ub9bd\uc2e0\uc7a5\uc7ac\ub2e8(National Kidney Foundation, NKF)\uc758 “Kidney Early Evaluation Program (KEEP)”\ub97c \ud1b5\ud574 \uc81c\uacf5\ub429\ub2c8\ub2e4. KEEP\uc5d0 \ub300\ud55c \uc790\uc138\ud55c \uc815\ubcf4\ub294 www.kidney.org\uc5d0\uc11c \ud655\uc778\ud560 \uc218 \uc788\uc2b5\ub2c8\ub2e4. <\/span>\u00a0<\/span><\/p>\n

        \uc54c\ubd80\ubbfc\ub1e8\ub97c \ud3c9\uac00\ud558\ub294 \uc77c\ubc18\uc801\uc778 \uc138 \uac00\uc9c0 \ubc29\ubc95\uc740 \ub2e4\uc74c\uacfc \uac19\uc2b5\ub2c8\ub2e4:<\/span><\/p>\n

        (1) 24\uc2dc\uac04 \uc18c\ubcc0 \uc218\uc9d1; (2) \uc2dc\uac04\ubcc4 \uc18c\ubcc0 \uc218\uc9d1 (\uc608: 4\uc2dc\uac04 \ub610\ub294 10\uc2dc\uac04\uac04\uaca9); \ub610\ub294 (3) \ubb34\uc791\uc704 \uc18c\ubcc0 \uc218\uc9d1\uc5d0\uc11c\uc758 \uc54c\ubd80\ubbfc\ub1e8-\ud06c\ub808\uc544\ud2f0\ub2cc \ube44\uc728 \uce21\uc815\uc785\ub2c8\ub2e4. \uc774 \uc911 \ub9c8\uc9c0\ub9c9 \ubc29\ubc95\uc774 \uac00\uc7a5 \ud3b8\ub9ac\ud558\uace0 \ube44\uc6a9 \ud6a8\uc728\uc801\uc774\ubbc0\ub85c \uc120\ud638\ub429\ub2c8\ub2e4(1).<\/p>\n

        \uc18c\ubcc0 \uac80\uccb4\ub97c \uc218\uc9d1\ud558\uace0 \ud3c9\uac00\ud55c \ud6c4, \uacb0\uacfc\ub294 \ubbf8\uc138\uc54c\ubd80\ubbfc\ub1e8(\uc54c\ubd80\ubbfc-\ud06c\ub808\uc544\ud2f0\ub2cc \ube44\uc728\uc774 30\uc5d0\uc11c 299 ug\/mg \uc0ac\uc774) \ub610\ub294 \uac70\ub300\uc54c\ubd80\ubbfc\ub1e8(\uc54c\ubd80\ubbfc-\ud06c\ub808\uc544\ud2f0\ub2cc \ube44\uc728 \u2265 300 ug\/mg)\ub85c \ubd84\ub958\ub420 \uc218 \uc788\uc2b5\ub2c8\ub2e4. \uc77c\uc2dc\uc801 \uc54c\ubd80\ubbfc\ub1e8\ub97c \ubc30\uc81c\ud558\uae30 \uc704\ud574(26) \ub2e4\uc74c 3~6\uac1c\uc6d4 \ub3d9\uc548 \ucd94\uac00\ub85c \ub450 \uac1c\uc758 \uac80\uccb4 \uc218\uc9d1\ud558\uc5ec \ubd84\ub958\ub97c \ud655\uc778\ud574\uc57c \ud569\ub2c8\ub2e4(24,25). <\/span>\u00a0<\/span><\/p>\n

        The Joint Committee on Diabetic Nephropathy\ub294 \ucd94\uc815\uc0ac\uad6c\uccb4\uc5ec\uacfc\uc728(eGFR) \ubc0f \ub9cc\uc131\ucf69\ud325\ubcd1(CKD)\uacfc \uac19\uc740 \ud575\uc2ec \uac1c\ub150\uc758 \uad11\ubc94\uc704\ud55c \uc0ac\uc6a9\uc5d0 \ub530\ub77c \ub2f9\ub1e8\uc131 \uc2e0\uc7a5\ubcd1\uc758 \ubd84\ub958(\ub2f9\ub1e8\uc131 \uc2e0\uc7a5\ubcd1 \ubd84\ub958 2014)\ub97c \uac1c\uc815\ud588\uc2b5\ub2c8\ub2e4. \ubd84\ub958\ub97c \uac1c\uc815\ud558\ub294 \uacfc\uc815\uc5d0\uc11c \uc704\uc6d0\ud68c\ub294 \uc774\ubc88 \uac1c\uc815\uacfc \uad00\ub828\ud558\uc5ec \uc77c\ubcf8 \ubcf4\uac74\ubcf5\uc9c0\ubd80(Ministry of Health, Labor and Welfare of Japan) \ub2f9\ub1e8\ubcd1\uc131\uc2e0\uc7a5\ubcd1\uc99d \uc5f0\uad6c \uadf8\ub8f9\uc774 \uc218\ud589\ud55c \uc5f0\uad6c \ubcf4\uace0\uc11c\ub97c \uc2e0\uc911\ud558\uac8c \ud3c9\uac00\ud588\uc2b5\ub2c8\ub2e4.<\/p>\n

        \ubd84\ub958\uc758 \uc8fc\uc694 \uac1c\uc815 \uc0ac\ud56d\uc740 \ub2e4\uc74c\uacfc \uac19\uc2b5\ub2c8\ub2e4:<\/span><\/p>\n

        (i) \ubd84\ub958\uc5d0\uc11c GFR\uc774 eGFR\ub85c \ub300\uccb4\ub418\uc5c8\uc2b5\ub2c8\ub2e4.<\/p>\n

        (ii) 3\uae30(\uba85\ubc31\ud55c \uc2e0\uc7a5\ubcd1\uc99d, overt nephropathy)\uc758 A \ubc0f B \ud558\uc704 \ubd84\ub958\uac00 \uc7ac\ud1b5\ud569\ub418\uc5c8\uc2b5\ub2c8\ub2e4(\ud45c 1).<\/p>\n

        (iii) 4\uae30(\ucf69\ud325 \uae30\ub2a5\uc0c1\uc2e4)\ub294 \uc54c\ubd80\ubbfc\ub1e8\uc758 \uc815\ub3c4\uc5d0 \uad00\uacc4\uc5c6\uc774 GFR\uc774 30 mL\/min\/1.73 m2 \ubbf8\ub9cc\uc73c\ub85c \uc7ac\uc815\uc758\ub418\uc5c8\uc2b5\ub2c8\ub2e4.<\/p>\n

        (iv) \ub2f9\ub1e8\ubcd1\uc2e0\uc7a5\ubcd1\uc99d\uacfc \ube44\ub2f9\ub1e8\ubcd1\uc2e0\uc7a5\ubcd1\uc99d\uc758 \uac10\ubcc4 \uc9c4\ub2e8\uc774 \ub2f9\ub1e8\ubcd1\uc2e0\uc7a5\ubcd1\uc99d\uc758 \ubaa8\ub4e0 \ub2e8\uacc4\uc5d0\uc11c \uc911\uc694\ud558\uac8c \uac15\uc870\ub418\uc5c8\uc2b5\ub2c8\ub2e4. <\/span><\/p>\n

         <\/p>\n

        \uadf8\ub9bc 5: \ub2f9\ub1e8\ubcd1\uc5d0\uc11c \ub2e4\uc591\ud55c \uac80\uc0ac \ubc29\ubc95\uc5d0 \ub530\ub978 \uc18c\ubcc0 \uc54c\ubd80\ubbfc \uc218\uce58\uc640 CKD\uc758 \ub2e8\uacc4. ACR(\uc54c\ubd80\ubbfc-\ud06c\ub808\uc544\ud2f0\ub2cc \ube44\uc728); CKD(\ub9cc\uc131\ucf69\ud325\ubcd1)(27). <\/span><\/p>\n

        \"\"<\/p>\n

         <\/p>\n

        \ud45c 1. \ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d \ubd84\ub958(28).<\/p>\n\n\n\n\n\n\n\n\n
        Stage<\/span>\u00a0<\/span><\/td>\nUrinary albumin (mg\/g Cr) or urinary protein (g\/g Cr)<\/span>\u00a0<\/span><\/td>\nGFR (eGFR) (mL\/min\/1.73\u202fm<\/span>2<\/span><\/sup>)<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
        Stage 1 (prenephropathy)<\/span>\u00a0<\/span><\/td>\nNormoalbuminuria\u00a0(<30)<\/span>\u00a0<\/span><\/td>\n\u226530<\/span>\u2021<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
        Stage 2 (incipient nephropathy)<\/span>\u00a0<\/span><\/td>\nMicroalbuminuria (30\u2013299)<\/span>\u00a7<\/span>\u00a0<\/span><\/td>\n\u226530<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
        Stage 3 (overt nephropathy)<\/span>\u00a0<\/span><\/p>\n

        (Subdivision A<\/span>\u00a0a<\/span>nd B integrated)<\/span>\u00a0<\/span><\/td>\n

        		Macroalbuminuria (\u2265300) or<\/span>\u00a0<\/span><\/p>\n

        persistent proteinuria (\u22650.5)<\/span>\u00a0<\/span><\/td>\n

        		\u226530<\/span>\u00b6<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
        Stage 4 (kidney failure)<\/span>\u00a0<\/span><\/td>\nAny albuminuria\/proteinuria status\u2020\u2020<\/span>\u00a0<\/span><\/td>\n<30<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
        Stage 5 (dialysis therapy)<\/span>\u00a0<\/span><\/td>\nAny status on continued dialysis therapy<\/span>\u00a0<\/span><\/td>\n\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
          \n
        • \u2020\ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d\uc740 \ud56d\uc0c1 \ud55c \ub2e8\uacc4\uc5d0\uc11c \ub2e4\uc74c \ub2e8\uacc4\ub85c \uc9c4\ud589\ub418\uc9c0 \uc54a\uc744 \uc218 \uc788\uc2b5\ub2c8\ub2e4. <\/span>\u00a0<\/span><\/li>\n
        • \u2021 60 mL\/min\/1.73 m2 \ubbf8\ub9cc\uc758 \uc0ac\uad6c\uccb4\uc5ec\uacfc\uc728(GFR)\uc740 \ub9cc\uc131\ucf69\ud325\ubcd1\uc758 \uc9c4\ub2e8\uacfc \uc77c\uce58\ud558\uc9c0\ub9cc, GFR\uc774 60 mL\/min\/1.73 m2 \ubbf8\ub9cc\uc778 \ud658\uc790\uc5d0\uc11c\ub294 \ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d \uc774\uc678\uc758 \uae30\uc800 \uc6d0\uc778\uc774 \uad00\uc5ec\ud560 \uc218 \uc788\uc73c\ubbc0\ub85c \ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d\uacfc \ub2e4\ub978 \uc7a0\uc7ac\uc801\uc778 \ube44\ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d \uac04\uc758 \uac10\ubcc4 \uc9c4\ub2e8\uc774 \ud544\uc694\ud560 \uc218 \uc788\uc2b5\ub2c8\ub2e4. <\/span>\u00a0<\/span><\/li>\n
        • \u00a7\ubbf8\uc138\uc54c\ubd80\ubbfc\ub1e8\ub97c \uac00\uc9c4 \ud658\uc790\ub294 \ub2f9\ub1e8\ubcd1\uc131\uc2e0\uc7a5\ubcd1\uc99d\uc758 \ucd08\uae30 \uc9c4\ub2e8 \uae30\uc900\uc5d0 \ub530\ub978 \uac10\ubcc4 \uc9c4\ub2e8 \ud6c4 \uc2e0\uc7a5\ubcd1\uc99d \ucd08\uae30 \ub2e8\uacc4\ub85c \uc9c4\ub2e8\ub418\uc5b4\uc57c \ud569\ub2c8\ub2e4. <\/span>\u00a0<\/span><\/li>\n
        • \u00b6 \uac70\ub300\uc54c\ubd80\ubbfc\ub1e8\ub97c \uac00\uc9c4 \ud658\uc790\ub4e4\uc740 \uc0ac\uad6c\uccb4\uc5ec\uacfc\uc728(GFR)\uc774 60 mL\/min\/1.73 m2 \ubbf8\ub9cc\uc73c\ub85c \uac10\uc18c\ud568\uc5d0 \ub530\ub77c \ucf69\ud325 \ubb38\uc81c\uac00 \uc99d\uac00\ud558\ub294 \uac83\uc73c\ub85c \ub098\ud0c0\ub0ac\uc73c\ubbc0\ub85c \uc8fc\uc758\uac00 \ud544\uc694\ud569\ub2c8\ub2e4(\uc608: \ucd94\uc815\uc0ac\uad6c\uccb4\uc5ec\uacfc\uc728[eGFR]\uc774 \uae30\uc900 \uac12\uc758 \uc808\ubc18\uc774 \ub418\ub294 \uac83, \ud22c\uc11d\uc774 \ud544\uc694\ud55c \uacbd\uc6b0). <\/span>\u00a0<\/span><\/li>\n
        • \u2020\u2020 30 mL\/min\/1.73 m2 \ubbf8\ub9cc\uc758 \uc0ac\uad6c\uccb4\uc5ec\uacfc\uc728(GFR)\uc744 \uac00\uc9c4 \ubaa8\ub4e0 \ud658\uc790\ub294 \uc54c\ubd80\ubbfc\ub1e8\/\ub2e8\ubc31\uc9c8 \uc218\uce58\uc640 \uc0c1\uad00\uc5c6\uc774 \ucf69\ud325\ubcd1\uc73c\ub85c \ubd84\ub958\ub429\ub2c8\ub2e4. \uadf8\ub7ec\ub098 \uc815\uc0c1 \uc54c\ubd80\ubbfc\ub1e8 \ubc0f \ubbf8\uc138\uc54c\ubd80\ubbfc\ub1e8\ub97c \uac00\uc9c4 \ud658\uc790\ub4e4\uc5d0\uc11c\ub294 \ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d\uacfc \ub2e4\ub978 \uc7a0\uc7ac\uc801\uc778 \ube44\ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d \uac04\uc758 \uac10\ubcc4 \uc9c4\ub2e8\uc774 \ud544\uc694\ud569\ub2c8\ub2e4. <\/span><\/li>\n<\/ul>\n

           <\/p>\n

          \ube44\ub85d \uac70\ub300\uc54c\ubd80\ubbfc\ub1e8\uac00 \uc911\uc99d \uc2e0\ubcd1\uc99d\uacfc \ub354 \ubc00\uc811\ud55c \uad00\ub828\uc774 \uc788\uc9c0\ub9cc, \ubbf8\uc138\uc54c\ubd80\ubbfc\ub1e8\ub3c4 \uc2e0\uc7a5 \uc190\uc0c1\uc758 \uc911\uc694\ud55c \ud45c\uc9c0\uc790\uc774\uc790 \uc2ec\ud608\uad00 \uc0ac\uac74\uc758 \uc608\uce21 \uc9c0\ud45c\uc785\ub2c8\ub2e4(25).<\/span><\/span><\/p>\n

          \ub9ce\uc740 2\ud615\ub2f9\ub1e8\ubcd1 \ud658\uc790\uc640 \ubbf8\uc138\uc54c\ubd80\ubbfc\ub1e8 \ud658\uc790\ub4e4\uc774 \uac70\ub300\uc54c\ubd80\ubbfc\ub1e8\ub098 \uc2e0\ubd80\uc804\uc73c\ub85c \uc9c4\ud589\ub418\uae30 \uc804\uc5d0 \uc2ec\ud608\uad00\uc73c\ub85c \uc0ac\ub9dd\ud558\uac8c \ub429\ub2c8\ub2e4(29). \ubbf8\uc138\uc54c\ubd80\ubbfc\ub1e8\uc640 \uc9c0\uc9c8 \uc774\uc0c1, \ub0b4\ud53c \uae30\ub2a5 \uc7a5\uc560, \ub9d0\ucd08 \ud608\uad00 \uc9c8\ud658, \uadf8\ub9ac\uace0 \ud608\uc804 \ud615\uc131\uacfc \uc2ec\ud608\uad00 \uc704\ud5d8 \uac04\uc758 \uc5f0\uad00\uc131\uc774 \uad00\ucc30\ub418\uc5c8\uc2b5\ub2c8\ub2e4(26). \ub530\ub77c\uc11c, \uc2e0\uae30\ub2a5 \uc7a5\uc560 \uc678\uc5d0\ub3c4 \ubbf8\uc138\uc54c\ubd80\ubbfc\ub1e8\ub294 \uc804\uc2e0 \ud608\uad00 \uae30\ub2a5 \uc7a5\uc560\uc640 \ub0b4\ud53c \uc190\uc0c1\uc758 \uc9c0\ud45c\uc785\ub2c8\ub2e4(26). <\/span><\/span>\u00a0<\/span><\/p>\n

           <\/p>\n

          \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1\uc758 \ubcd1\ub9ac\uc0dd\ub9ac\ud559<\/strong> <\/span><\/p>\n

          \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1\uc758 \ubcd1\ub9ac\uc0dd\ub9ac\ud559\uc740 \ubcf5\uc7a1\ud558\uace0 \ub2e4\uc591\ud55c \uc694\uc778\uc5d0 \uc758\ud574 \ubc1c\uc0dd\ud569\ub2c8\ub2e4. \ub450 \uac00\uc9c0 \uc8fc\uc694 \uae30\uc804\uc774 \uc81c\uc548\ub418\uc5c8\ub294\ub370, \ub458 \ub2e4 \uace0\ud608\ub2f9\uc5d0 \uc758\ud574 \uc2dc\uc791\ub429\ub2c8\ub2e4(\uadf8\ub9bc 3 \ucc38\uc870). \uccab \ubc88\uc9f8 \uae30\uc804\uc740 \uace0\ud608\ub2f9\uc774 \ub2e8\ubc31\uc9c8 \ub2f9\ud654(glycosylation)\ub97c \uc720\ubc1c\ud558\uace0, \uc774\ub294 \ub2e4\uc2dc \uc0ac\uad6c\uccb4 \ube44\ub300\ub97c \uc77c\uc73c\ucf1c \uacb0\uad6d \uacbd\ud654\uc99d(sclerosis)\uc73c\ub85c \uc774\uc5b4\uc9c4\ub2e4\ub294 \uac83\uc785\ub2c8\ub2e4. \ub450 \ubc88\uc9f8 \uae30\uc804\uc740 \uace0\ud608\ub2f9\uc774 \ud608\uad00\ud655\uc7a5\uc744 \uc720\ubc1c\ud558\uace0, \uadf8 \ud6c4\uc5d0 \uacfc\uc5ec\uacfc(hyperfiltration), \ube44\uc815\uc0c1\uc801\uc778 \uc548\uc9c0\uc624\ud150\uc2e0 II \ubc18\uc751, \ube44\uc815\uc0c1\uc801\uc778 \uc5d4\ub3c4\ud154\ub9b0\/\uc544\uc0b0\ud654\uc9c8\uc18c(NO) \ubc18\uc751, \uc131\uc7a5 \ud638\ub974\ubaac \ubd84\ube44 \uc99d\uac00, \uace0\uc778\uc290\ub9b0\ud608\uc99d \uadf8\ub9ac\uace0 \uacbd\ud654\uc99d\uc774 \ub098\ud0c0\ub09c\ub2e4\ub294 \uac83\uc785\ub2c8\ub2e4(30\u201332). \uc774\ub7ec\ud55c \uacfc\uc815\ub4e4\uc740 \ud65c\uc131\uc0b0\uc18c\uc885(reactive oxygen species)\uacfc \uc5fc\uc99d \ub9e4\uac1c\uccb4\uc758 \ubd84\ube44\ub97c \ucd09\uc9c4\ud569\ub2c8\ub2e4. \uc774\ub7ec\ud55c \ubcc0\ud654\ub4e4\uc740 \ucd1d\uccb4\uc801\uc73c\ub85c \uc0ac\uad6c\uccb4 \uacfc\uc5ec\uacfc, \uc0ac\uad6c\uccb4 \uace0\ud608\uc555, \ucf69\ud325 \ube44\ub300, \uadf8\ub9ac\uace0 \uc0ac\uad6c\uccb4\uc758 \uad6c\uc870 \ubcc0\ud654\ub85c \uc774\uc5b4\uc9c0\uba70, \uc784\uc0c1\uc801\uc73c\ub85c \uc54c\ubd80\ubbfc\ub1e8\uc640 \uace0\ud608\uc555\uc73c\ub85c \ub098\ud0c0\ub0a9\ub2c8\ub2e4. \ubcd1\ub9ac\ud559\uc801\uc73c\ub85c \ucf69\ud325\uc740 \uc5ec\ub7ec \ubcc0\ud654\uac00 \uc77c\uc5b4\ub098\ub294\ub370, \uc774 \uc911\uc5d0\ub294 \uba54\uc0b0\uc9c0\uc6c0(mesangium)\uc5d0 \ub300\ud55c \uc138\ud3ec\uc678\uae30\uc9c8\uc758 \uce68\ucc29, \uc0ac\uad6c\uccb4 \uae30\uc800\ub9c9\uc758 \ub450\uaebc\uc6cc\uc9d0, \uc99d\uc2dd\uc131 \ubcc0\ud654 \ubc0f \uc138\ub1e8\uad00 \uc704\ucd95 \ub4f1\uc774 \ud3ec\ud568\ub418\uba70, \uacb0\uad6d\uc5d0\ub294 \uc0ac\uc774\uc9c8\uc12c\uc720\ud654 \ubc0f \uc0ac\uad6c\uccb4\uacbd\ud654\uc99d(\ub9ce\uc740 \ucf69\ud325 \uc9c8\ud658\uc758 \ucd5c\uc885 \uacf5\ud1b5 \uacbd\ub85c)\uc744 \ucd08\ub798\ud558\uac8c \ub429\ub2c8\ub2e4. \uc774 \uacfc\uc815\uc744 \ubb18\uc0ac\ud55c \ub3c4\uc2dd\uc740 \uadf8\ub9bc 6\uc5d0 \ub098\uc640 \uc788\uc2b5\ub2c8\ub2e4. <\/span><\/p>\n

           <\/p>\n

          \uadf8\ub9bc 6 \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1\uc758 \ubcd1\ub9ac\uc0dd\ub9ac\ud559(33). \uc57d\uc5b4: AGE, advanced glycation end product(\ucd5c\uc885\ub2f9\ud654\uc0b0\ubb3c); ECM, extracellular matrix(\uc138\ud3ec\uc678 \uae30\uc9c8); \u2206s, changes(\ucc28\uc774).<\/p>\n

          \"\"<\/p>\n

           <\/p>\n

          \ubcd1\ub9ac\ud559\uc801 \ubd84\ub958:<\/strong> <\/span><\/b>\u00a0<\/span><\/p>\n

          2010\ub144, Tervaert et al.\uc740 the Renal Pathology Society\uc758 \uc5f0\uad6c\uc704\uc6d0\ud68c\uc5d0 \uc758\ub8b0\ub97c \ubc1b\uc544 \uc0ac\uad6c\uccb4 \ubcd1\ubcc0\uc758 \uc2ec\uac01\uc131\uc744 \uae30\ubc18\uc73c\ub85c \ud55c \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1(DKD)\uc758 \ubcd1\ub9ac\ud559\uc801 \ubd84\ub958 \uc2dc\uc2a4\ud15c\uc744 \uc81c\uc548\ud558\uc600\uc2b5\ub2c8\ub2e4(33). \uc774 \ubd84\ub958 \uc2dc\uc2a4\ud15c\uc5d0 \ub530\ub974\uba74, \uc0ac\uad6c\uccb4 \uc0dd\uac80\uc740 4\uac00\uc9c0 \ubd84\ub958 \uc911 \ud558\ub098\ub85c \ub098\ub220\uc9d1\ub2c8\ub2e4. \uc5ec\uae30\uc11c Class 1\uc740 \uacbd\uc99d \uc2e0\uc7a5\ubcd1, 4\ub4f1\uae09\uc740 \uc911\uc99d \uc2e0\uc7a5\ubcd1\uc744 \uc758\ubbf8\ud569\ub2c8\ub2e4.\u202f<\/span>\u00a0<\/span><\/p>\n

            \n
          • Class I:<\/strong> \uc0ac\uad6c\uccb4 \uae30\uc800\ub9c9(GBM) \ube44\ub300: \uc5ec\uc131\uc5d0\uc11c 395nm\ub97c \ucd08\uacfc\ud558\uace0, \ub0a8\uc131\uc5d0\uc11c\ub294 430nm\ub97c \ucd08\uacfc\ud558\ub294 \ub2e8\ub3c5 GBM \ube44\ub300\ub85c, \uad11\ud559 \ud604\ubbf8\uacbd\uc73c\ub85c \uad00\ucc30\ub418\ub294 \ubcc0\ud654\ub294 \uacbd\ubbf8\ud558\uace0 \ube44\ud2b9\uc774\uc801\uc774\uc5b4\uc11c Class II~IV\uc758 \uae30\uc900\uc744 \ucda9\uc871\ud558\uc9c0 \uc54a\uc74c. <\/span><\/li>\n
          • Class IIa:<\/strong> \uacbd\uc99d(mild) \uba54\uc0b0\uc9c0\uc6c0 \ud655\uc7a5: \uc0ac\uad6c\uccb4\uac00 \uacbd\ubbf8\ud55c \uba54\uc0b0\uc9c0\uc6c0 \ud655\uc7a5\uc73c\ub85c \ubd84\ub958\ub418\ub098(\uad00\ucc30\ub41c \uba54\uc0b0\uc9c0\uc6c0\uc758 25%\uc774\uc0c1\uc774 \ubaa8\uc138\ud608\uad00 \ub0b4\uac15 \uba74\uc801\ubcf4\ub2e4 \uc791\uc740 \uba74\uc801\uc744 \ucc28\uc9c0), \uacb0\uc808\uc131 \uacbd\ud654\uc99d(Kimmelstiel-Wilson \ubcd1\ubcc0)\uc774\ub098 \uc804\ubc18\uc801\uc778 \uc0ac\uad6c\uccb4\uacbd\ud654\uc99d\uc774 \uc0ac\uad6c\uccb4\uc758 50% \uc774\uc0c1\uc5d0\uc11c \ub098\ud0c0\ub098\uc9c0 \uc54a\uc74c. <\/span><\/li>\n
          • Class IIb:<\/strong> \uc911\uc99d(severe) \uba54\uc0b0\uc9c0\uc6c0 \ud655\uc7a5: \uc0ac\uad6c\uccb4\uac00 \uc911\uc99d \uba54\uc0b0\uc9c0\uc6c0 \ud655\uc7a5\uc73c\ub85c \ubd84\ub958\ub418\uba70(\uad00\ucc30\ub41c \uba54\uc0b0\uc9c0\uc6c0\uc758 25% \uc774\uc0c1\uc774 \ubaa8\uc138\ud608\uad00 \ub0b4\uac15 \uba74\uc801\ubcf4\ub2e4 \ud070 \uba74\uc801\uc744 \ucc28\uc9c0), \uacb0\uc808\uc131 \uacbd\ud654\uc99d\uc774 \uc5c6\uace0, \uc0dd\uac80\uacb0\uacfc\uac00 Class III \ub610\ub294 IV \uae30\uc900\uc5d0 \ud574\ub2f9\ud558\uc9c0 \uc54a\uc74c.<\/li>\n
          • Class III:<\/strong> \uacb0\uc808\uc131 \uacbd\ud654\uc99d(Kimmelstiel\u2013Wilson \ubcd1\ubcc0): \ucd5c\uc18c \ud55c \uac1c\uc758 \uc0ac\uad6c\uccb4\uc5d0\uc11c \uba54\uc0b0\uc9c0\uc6c0 \uae30\uc9c8\uc758 \uacb0\uc808\uc131 \uc99d\uac00(Kimmelstiel\u2013Wilson)\uac00 \ub098\ud0c0\ub098\uc9c0\ub9cc, Class IV\uc5d0\uc11c \uc124\uba85\ub41c \ubcc0\ud654\ub294 \uc5c6\uc74c. <\/span><\/li>\n
          • Class IV:<\/strong> \uc9c4\ud589\ub41c(advanced) \ub2f9\ub1e8\ubcd1 \uc0ac\uad6c\uccb4\uacbd\ud654\uc99d: \uc804\uccb4 \uc0ac\uad6c\uccb4 \uacbd\ud654\uc99d\uc774 50% \uc774\uc0c1 \uad00\ucc30\ub418\uba70, \uc774 \uacbd\ud654\uc99d\uc774 \ub2f9\ub1e8\ubcd1\uc2e0\uc7a5\ubcd1\uc99d\uacfc \uad00\ub828\ub41c \uac83\uc774\ub77c\ub294 \uc784\uc0c1\uc801 \ub610\ub294 \ubcd1\ub9ac\ud559\uc801 \uc99d\uac70\uc640 Class I-III \ubcd1\ubcc0\uc774 \ud568\uaed8 \ub098\ud0c0\ub0a8. <\/span><\/li>\n<\/ul>\n

            \uc81c\uc548\ub41c \ubd84\ub958 \uccb4\uacc4\ub294 \ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d\uc758 \ubcf5\uc7a1\ud55c \uacbd\ub85c\uc5d0 \ub300\ud55c \uc0c8\ub85c\uc6b4 \ud1b5\ucc30\ub825\uc744 \uc81c\uacf5\ud560 \uc218 \uc788\uc744 \uac83\uc73c\ub85c \uc608\uc0c1\ub429\ub2c8\ub2e4. \uadf8\ub7ec\ub098 \uc774 \uc5f0\uad6c\uc5d0\uc11c\ub294 \uc784\uc0c1\uc801 \uacb0\uacfc\ub97c \ud3c9\uac00\ud558\uc9c0 \uc54a\uc558\ub294\ub370, \uc5f0\uad6c\uc790\ub4e4\uc740 \uba85\ud655\ud558\uac8c \uc815\uc758\ub41c \uc784\uc0c1 \uc885\uc810\uc744 \uac16\ucd98 \ubcc4\ub3c4\uc758 \uc804\ud5a5\uc801 \uc5f0\uad6c\uc5d0\uc11c \uac80\uc99d \uc791\uc5c5\uc774 \uc774\ub8e8\uc5b4\uc838\uc57c \ud55c\ub2e4\uace0 \ud310\ub2e8\ud588\uae30 \ub54c\ubb38\uc785\ub2c8\ub2e4(25,33).<\/p>\n

            \uce58\ub8cc:<\/strong> <\/span><\/p>\n

            \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1(DKD)\uc758 \ucd5c\uc801 \uce58\ub8cc\ubc95\uc740 \uacc4\uc18d \ubc1c\uc804\ud558\uace0 \uc788\uc2b5\ub2c8\ub2e4. ADA (\ubbf8\uad6d\ub2f9\ub1e8\ubcd1\ud559\ud68c) \ubc0f NKF-KDOQI\uc758 \uc9c0\uce68\uc740 \ub2f9\ub1e8\ubcd1\ucf69\ud325\ubcd1\uc758 \uc9c4\ud589\uc744 \uac10\uc18c\uc2dc\ud0a4\uae30 \uc704\ud574 \ud608\ub2f9 \ubc0f \ud608\uc555\uc744 \uc5c4\uaca9\ud558\uac8c \uad00\ub9ac\ud558\uace0, \ub808\ub2cc-\uc548\uc9c0\uc624\ud150\uc2e0 \uc2dc\uc2a4\ud15c \uc5b5\uc81c\uc758 \uc774\uc810\uc744 \uac15\uc870\ud569\ub2c8\ub2e4. \ucd5c\uadfc \uc5f0\uad6c\uc5d0\uc11c\ub294 \uace0\uac15\ub3c4\uc758 \ud608\ub2f9 \uad00\ub9ac\uac00 DKD \uc9c4\ud589\uc758 \uc704\ud5d8\uc744 \uc904\uc774\uac70\ub098 \uc784\uc0c1 \uacb0\uacfc\ub97c \ud5a5\uc0c1\uc2dc\ud0a4\uc9c0 \ubabb\ud588\uc73c\uba70, \uc624\ud788\ub824 \uc800\ud608\ub2f9\uc758 \uc704\ud5d8\uc744 \uc99d\uac00\uc2dc\ucf30\ub2e4\ub294 \uac83\uc774 \ubc1d\ud600\uc84c\uc2b5\ub2c8\ub2e4(28). ADA\ub294 \ub098\uc774, \ub3d9\ubc18 \uc9c8\ud658 \ubc0f \uae30\ub300 \uc218\uba85\uc5d0 \uae30\ubc18\ud55c \uac1c\ubcc4\ud654\ub41c \ud608\ub2f9 \uad00\ub9ac \ubaa9\ud45c\ub97c \uad8c\uc7a5\ud569\ub2c8\ub2e4(34). \ud604\uc7ac KDOQI\uc640 KDIGO \uc784\uc0c1\uc9c4\ub8cc\uc9c0\uce68\uc740 \ub3d9\ubc18 \uc9c8\ud658, \uae30\ub300 \uc218\uba85\uc774 \uc81c\ud55c\ub41c \ud658\uc790 \ubc0f \uc800\ud608\ub2f9 \uc704\ud5d8\uc774 \uc788\ub294 \ud658\uc790(\ud2b9\ud788 \ud22c\uc11d\uc744 \ubc1b\ub294 \ub9d0\uae30 CKD \ud658\uc790 \ud3ec\ud568)\uc758 \uacbd\uc6b0 HbA1c \ubaa9\ud45c\ub97c 7% \uc774\uc0c1\uc73c\ub85c \ub192\uc77c \uac83\uc744 \uad8c\uc7a5\ud569\ub2c8\ub2e4(25). \uace0\ud608\uc555 \uad00\ub9ac\uc5d0 \ub300\ud55c ‘\uc131\uc778 \uace0\ud608\uc555\uc758 \uc608\ubc29, \ubc1c\uacac, \ud3c9\uac00 \ubc0f \uad00\ub9ac \uc9c0\uce68’\uc740 \uc218\ucd95\uae30 \ud608\uc555\uc774 130 mmHg \uc774\uc0c1 \ub610\ub294 \uc774\uc644\uae30 \ud608\uc555\uc774 80 mmHg \uc774\uc0c1\uc77c \ub54c \uc57d\ubb3c \uce58\ub8cc\ub97c \uc2dc\uc791\ud558\ub294 \uac83\uc744 \uad8c\uc7a5\ud569\ub2c8\ub2e4. \uad8c\uc7a5\ub41c \ud608\uc555 \ubaa9\ud45c\ub294 \ub2f9\ub1e8\ubcd1 \uc5ec\ubd80\uc640 \uad00\uacc4\uc5c6\uc774 CKD \ud658\uc790\uc5d0\uac8c \ub3d9\uc77c\ud558\uac8c \uc801\uc6a9\ub429\ub2c8\ub2e4(25). DKD \ud658\uc790\uc758 \uc57d\ubb3c \uce58\ub8cc\ub294 ACE \uc5b5\uc81c\uc81c \ub610\ub294 ARB\ub97c \ub2e8\ub3c5\uc73c\ub85c \ub610\ub294 \ub2e4\ub978 \ud608\uc555 \uc57d\ubb3c\uacfc \ubcd1\uc6a9\ud558\ub294 \uac83\uc744 \ud3ec\ud568\ud574\uc57c \ud569\ub2c8\ub2e4(25). DKD \uce58\ub8cc\uc5d0 \ub300\ud55c \ud604\uc7ac\uc758 \uce58\ub8cc \uc811\uadfc\ubc95\uc5d0\ub3c4 \ubd88\uad6c\ud558\uace0, \uc2e0\uaddc \uce58\ub8cc \uc635\uc158\uc740 \uc0ac\uad6c\uccb4 \uacfc\uc5ec\uacfc, \uc5fc\uc99d \ubc0f \uc12c\uc720\ud654\ub97c \ud45c\uc801\uc73c\ub85c \ud558\ub294 \uae30\uc804\uc5d0 \ucd08\uc810\uc744 \ub9de\ucd94\uace0 \uc788\uc73c\uba70, \uc774\ub294 \ud5a5\ud6c4 \uc774 \uc9c8\ud658\uc758 \uce58\ub8cc \ubc29\ubc95\uc744 \ubcc0\ud654\uc2dc\ud0ac \uc218 \uc788\uc2b5\ub2c8\ub2e4(36). \uc774 \uc778\uad6c\uc5d0\uc11c \uc2ec\ud608\uad00\uacc4 \uc9c8\ud658\uc73c\ub85c \uc778\ud55c \uc0ac\ub9dd\ub960\uc774 \ub192\uae30 \ub54c\ubb38\uc5d0 \uc774\uc0c1\uc9c0\uc9c8\ud608\uc99d\uacfc \uac19\uc740 \uc2ec\ud608\uad00 \uc9c8\ud658\uc758 \ub2e4\ub978 \uc704\ud5d8 \uc694\uc18c\ub97c \uad00\ub9ac\ud558\ub294 \uac83\ub3c4 \ub9e4\uc6b0 \uc911\uc694\ud569\ub2c8\ub2e4(25,34). \ub2f9\ub1e8\ubcd1\uc2e0\ubcd1\uc99d\uc758 \uc9c4\ub2e8 \ubc0f \uce58\ub8cc\uc5d0 \ub300\ud55c \uc790\uc138\ud55c \uc815\ubcf4\ub294 \ubbf8\uad6d\ub2f9\ub1e8\ubcd1\ud559\ud68c(ADA) \uc6f9\uc0ac\uc774\ud2b8(professional.diabetes.org) \ub610\ub294 \ubbf8\uad6d\uad6d\ub9bd\uc2e0\uc7a5\ud559\uc7ac\ub2e8(National Kidney Foundation) \uc6f9\uc0ac\uc774\ud2b8(www.kidney.org)\uc5d0\uc11c \ucc3e\uc744 \uc218 \uc788\uc2b5\ub2c8\ub2e4. <\/span><\/p>\n

            <\/div>
            <\/div>\n

            \ucc38\uace0\ubb38\ud5cc<\/strong><\/h4>\n
              \n
            1. Trujillo J, Haines S. Diabetes Mellitus. In: DiPiro JT, Yee GC, Posey LM, Haines ST, Nolin TD, Ellingrod V, eds.\u00a0<\/span>Pharmacotherapy: A Pathophysiologic Approach, 11e<\/span><\/i>. McGraw-Hill Education; 2020. Available from: http:\/\/accesspharmacy.mhmedical.com\/content.aspx?aid=1166578968.<\/span>\u00a0<\/span><\/li>\n
            2. Centre for Disease Control and Prevention. National Diabetes Statistics Report, 2020.<\/span>Natl Diabetes Stat Rep<\/span><\/i>. Published online 2020:2. Available from: https:\/\/www.cdc.gov\/diabetes\/pdfs\/data\/statistics\/national-diabetes-statistics-report.pdf.<\/span>\u00a0<\/span><\/li>\n
            3. Funk JL. Disorders of the Endocrine Pancreas. In: Hammer GD, McPhee SJ, eds.<\/span>Pathophysiology of Disease: An Introduction to Clinical Medicine, 8e<\/span><\/i>. McGraw-Hill Education; 2019. Available from: http:\/\/accessmedicine.mhmedical.com\/content.aspx?aid=1156659591.<\/span>\u00a0<\/span><\/li>\n
            4. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9<\/span>th<\/span>edition.\u00a0<\/span>Diabetes Res Clin Pract<\/span><\/i>. 2019;157. Available from: https:\/\/doi.org\/10.1016\/j.diabres.2019.107843.<\/span>\u00a0<\/span><\/li>\n
            5. Centers for Disease Control and Prevention. Diabetes Report Card, 2017. Atlanta,GA. Available from: https:\/\/www.cdc.gov\/diabetes\/pdfs\/library\/diabetesreportcard2017-508.pdf.<\/span><\/li>\n
            6. Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012.<\/span>JAMA<\/span><\/i>. 2015;314(10):1021-1029. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26348752.<\/span>\u00a0<\/span><\/li>\n
            7. Geiss LS, Pan L, Cadwell B, Gregg EW, Benjamin SM, Engelgau MM. Changes in incidence of diabetes in U.S. adults, 1997-2003.<\/span>Am J Prev Med<\/span><\/i>. 2006;30(5):371-377. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/16627124.<\/span>\u00a0<\/span><\/li>\n
            8. Moore PA, Zgibor JC, Dasanayake AP. Diabetes: a growing epidemic of all ages.<\/span>J Am Dent Assoc<\/span><\/i>. 2003;134 Spec N:11S-15S. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/18196668.<\/span>\u00a0<\/span><\/li>\n
            9. Reinehr T. Type 2 diabetes mellitus in children and adolescents.<\/span>World J Diabetes<\/span><\/i>. 2013;4(6):270-281. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/24379917.<\/span>\u00a0<\/span><\/li>\n
            10. Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M. Type 2 Diabetes in the Young: The Evolving Epidemic.<\/span>Diabetes Care<\/span><\/i>. 2004;27(7):1798 LP – 1811. Available from: http:\/\/care.diabetesjournals.org\/content\/27\/7\/1798.abstract.<\/span>\u00a0<\/span><\/li>\n
            11. NCHS Fact Sheet, December 2017. Centers for Disease Control and Prevention. Available from: https:\/\/www.cdc.gov\/nchs\/about\/factsheets\/factsheet_nhanes.htm.<\/span><\/li>\n
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            13. Pippitt K, Li M, Gurgle HE. Diabetes Mellitus: Screening and Diagnosis.<\/span>Am Fam Physician<\/span><\/i>. 2016;93(2):103-109. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/26926406.<\/span>\u00a0<\/span><\/li>\n
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              \u00a0 \u00a0 P\/N 101290-01 Rev<\/span>\u00a0<\/span>A<\/span>\u00a0<\/span>3<\/span>\/20<\/span>2<\/span>0<\/span>\u00a0<\/span><\/p>\n

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