The development and treatment of diabetic nephropathy

Diabetic patients with kidney disease, diabetes usually after 10 to 20 years , about half of the occurrence of renal insufficiency. Diabetes is mainly caused systemic capillary lesions, resulting in capillary basement membrane thickening , microcirculation abnormalities in the kidney glomerular basement membrane thickening that occurs , leading to glomerulosclerosis . Glomerular filtration rate decreased , leading to kidney failure .
Generally first appear asymptomatic proteinuria , suggesting that diabetic nephropathy has already begun. At the start of intermittent proteinuria may , thereafter, becomes persistent . The gradual emergence of edema, hypertension. Generally speaking , the longer history of diabetes , the more severe glomerular sclerosis , the greater proteinuria, if the urine protein greater than 3.5 grams per day , nephrotic syndrome may occur . The prognosis is poor , often die within five years of renal failure and cardiovascular disease.
There is a characteristic . When renal failure, renal no obvious narrowing .
Patients with diabetes , we must be well controlled blood sugar, can delay or reduce the incidence of diabetic nephropathy. A diet, proper application of two antidiabetic drugs , can prevent secondary kidney damage. Three diabetic nephropathy corticosteroids should not be used , it is not only ineffective for proteinuria and nephrotic syndrome , and will lead to infection, make blood sugar more difficult to control . Nephrotic syndrome more severe edema , diuretics available . High blood pressure , antihypertensive treatment is appropriate , ARB and vascular converting enzyme inhibitors reduce glomerular filtration pressure , not only the blood pressure, proteinuria, and delaying and reducing the incidence of renal failure , can be routinely used. Renal failure, renal failure and the general treatment of the same .

It should be noted that the occurrence of renal failure, diabetic nephropathy , should use insulin injections , diabetes, kidney disease requiring dialysis due when patients often have atherosclerosis, coronary heart disease, retinopathy , severe coronary artery disease , peripheral vascular disease resulting in fistula for blood through difficulties and severe retinopathy is more appropriate peritoneal dialysis .