Symptoms of diabetic nephropathy and staging

Symptoms of diabetic nephropathy and staging. Is very much the type of kidney disease, and for that matter, most of the friends can say a few years, for example, the more common kidney uremia, hydronephrosis, etc., but I do not know does not mean that the disease exist.
What are the symptoms of diabetic nephropathy and staging it?
Reflect
1, no proteinuria early clinical proteinuria in diabetic nephropathy, only by radioimmunoassay talent detect microalbuminuria. Pre-diabetic nephropathy specific clinical manifestation of proteinuria, proteinuria gradually unfold from intermittent to continue resistance.
2, pre-diabetic nephropathy clinical edema usually no edema, a small number of patients before lowering plasma protein, may have mild edema. If a lot of proteinuria, low plasma protein, increased edema, mostly carried out to late disease expression.
3, high blood pressure in type 1 diabetic patients without nephropathy prevalence of hypertension than normal does not add, type 2 diabetes and hypertension are more, but if the time share presentation hypertension also increased proteinuria in kidney disease when syndrome patients with hypertension, this mostly moderate hypertension, a small number of severe.
4, there is a big difference with renal failure and diabetic nephropathy launch speed. Some patients with mild proteinuria may continue for many years, but with normal renal function, some patients with proteinuria few quick launch presented nephrotic syndrome, renal function progressively worse, eventually showing uremia.
5, anemia in patients with significant azotemia, may have mild anemia.
6, other organ complications such as cardiovascular disease embody heart failure, myocardial infarction. Neuropathy, such as peripheral neuropathy. When presented with neurogenic bladder may involve autonomic nervous. Retinopathy, diabetic nephropathy almost 100% when severe diabetic retinopathy, but there are severe retinopathy significantly divergent set of kidney disease. When carried out with diabetic nephropathy, retinopathy often accelerate deterioration.
Staging
Ⅰ period: increase in glomerular filtration rate and renal volume increases as features. This precancerous lesions and high blood sugar levels together, but reversible, by insulin treatment can be recovered, but divergent set to completely recover to normal.
Ⅱ period: The period of normal urinary albumin excretion rate, but has shown signs of glomerular structural changes. This issue of urinary albumin excretion rate (UAE) normal (<20μg / min or <30mg / 24h), after the group increased after exercise UAE rest can recover. The structure of the glomerular changes have been presented, glomerular basement membrane (GBM) thickening and mesangial matrix spike, GFR much higher than normal blood sugar levels with a common, GFR> 150mL / min in patients with glycated hemoglobin often > 9.5%. GFR> 150mL / min and the UAE> patient 30μg / min easier to conduct future clinical diabetic nephropathy. Diabetic kidney damage Ⅰ, Ⅱ patients blood pressure were normal. Ⅰ, GFR Ⅱ patients increased, UAE normal, therefore can not be called the second phase of diabetic nephropathy.
Stage Ⅲ: also known as pre-diabetic. Urinary albumin excretion rate 20--200μg / min, slightly elevated blood pressure, glomerular Kuang fees began to appear.
Stage Ⅳ: clinical diabetic nephropathy or overt diabetic nephropathy. This period was characterized by a lot of albuminuria (greater than 3.5 grams per day), edema and hypertension. Diabetic nephropathy is more severe edema, diuretics poor response.
Ⅴ stage: the end of advanced renal failure. Once the presentation of diabetes continues to carry out clinical proteinuria in diabetic nephropathy, glomerular basement membrane as a result of extensive thickening of the glomerular capillary cavity narrow and more glomeruli Kuang fees were reduced kidney filtration function , resulting in renal failure

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