Diabetic Nephropathy is one of the most important complications in diabetic patients. In recent years, its morbidity increases gradually. The latest data show that it is the leading cause of kidney failure. Once it goes into ESRD, it is often often difficult to treat than other kidney diseases, so timely prevention and treatment of Diabetic Nephropathy is of great significance.
Diabetic Nephropathy generally goes through the following stages:
1. In early stage, microalbuminuria appears and then becomes urinary routine proteins. This symptom can last for a while, but then the glomerular filtration rate drops and the severity of kidney disease slowly increases.
2. Some minor physical changes, such as minor edema (foot surface, ankle, calf, eyelid, etc.), are found with the progression of the disease. The occurrence of systemic edema indicates that the disease of diabetic patients has been progressing continuously.
3. Hypertension also develops over time, as a result of the presence of some of the early symptoms.
4. In severe case, it can go into kidney failure. In the early stage of Diabetic Nephropathy, in order to adapt to the needs of the body's sugar excretion, the glomerular filtration rate increases, but urea nitrogen and creatinine level is normal. Once continuous proteinuria occurs in the body, the patient's blood urea nitrogen and creatinine concentration will increase, thereby showing renal insufficiency. Without timely control, Diabetic Nephropathy will progress into uremia within a few years.
What examinations can diabetics do to discover kidney damage early?
1. Type 1 diabetes should be diagnosed 5 years after diagnosis, and type 2 diabetes should be screened annually for diabetic kidney disease after diagnosis is established.
2. Screening index:
-Testing of urinary microalbumin: this index is the earliest and most sensitive index to diagnose diabetic renal disease. The urine can be retained for 24 hours for quantification, or it can be retained for a period of time (e.g. 8 hours) to calculate the albumin excretion rate; The albumin/creatinine ratio (ACR) is calculated by detecting albumin and creatinine concentration in single urine specimens at any time. Patients are required to exclude urinary tract infections when urinating. Due to the variation of albumin excretion in human urine under physiological state (influenced by factors such as day and night, exercise and blood sugar), it should be reviewed 1-2 times in the next 3-6 months.
-Glomerular filtration rate (GFR) : an important indicator of renal function. Serum creatinine can be measured by formula calculation of estimated GFR or by direct examination of kidney ect.
When patients are diagnosed with microalbuminuria or a large amount of albuminuria, and have diabetic retinopathy confirmed by fundus examination, the patient's kidney disease is often considered to be attributed to diabetes, which is what we call Diabetic Nephropathy.
me patients with early diabetic nephropathy can return to normal through active treatment. About half of the patients can stay in the stage of microalbuminuria for a long time without progress, and only a few will gradually progress to clinical proteinuria. For diabetics with massive proteinuria, it is also not necessarily progress to uremia. One one hand, their proteinuria may not be caused by diabetic nephropathy. Some studies found that people with diabetes in other primary glomerular disease did not differ between the proportion with the diabetic population. For such patients, positive treatment can make turn proteinuria negative. In my clinical observations, many Diabetic Nephropathy patients with clinical proteinuria can keep kidney function normal for over 10 years.
All in all, Diabetic Nephropathy treatment is a long course. The earlier you detect the disease, the better. For more information on Diabetic Nephropathy, please leave a message below or contact online doctor.
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