How is diabetic nephropathy diagnosed?

Written by Zhou Qi
Nephrology
Updated on September 01, 2024
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The diagnosis of diabetic nephropathy primarily relies on the clinical symptoms and medical history of the patient. Such patients often exhibit proteinuria, sometimes even severe proteinuria, and may also experience renal failure. Additionally, these patients have a history of diabetes, usually extending over ten years, followed by renal damage, and often accompanied by diabetic retinopathy. In such cases, a preliminary diagnosis can be made based on clinical features. However, there is still a risk of misdiagnosis, as the proteinuria could also be caused by other diseases affecting the glomeruli. Therefore, to confirm the diagnosis, it is best to conduct a renal biopsy, which can provide a definitive diagnosis.

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Written by Zhou Qi
Nephrology
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Symptoms of stage 2 diabetic nephropathy

Diabetic nephropathy is divided into five stages. Speaking in terms of the severity of the condition, in the second stage, the clinical manifestations are not very obvious, and the patient's kidney size may increase. Generally, at rest, the patient's urine protein is negative, but after activity, there might be traces of albumin in the urine. Due to the presence of a small amount of protein in the urine, there may be an increase in urine foam, and the patient may experience mild edema, although the symptoms of this edema are also not very noticeable. At this stage, the damage of diabetes to other organs of the body is not very evident, therefore, retinopathy is not severe, and the patient’s vision decline is not significant. The patient may also have concurrent issues like hypertension and hyperlipidemia.

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Written by Zhou Qi
Nephrology
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Which department to see for diabetic nephropathy?

In principle, patients with diabetic nephropathy should seek treatment in the nephrology department of a formal public hospital. Diabetes occurs when there is an absolute deficiency or relative insufficiency in insulin secretion, leading to a state characterized by high blood sugar and various metabolic waste disorders. Such a syndrome can cause damage to multiple organs. The kidneys are a major target organ for damage, and as kidney disease develops, patients may experience proteinuria and potentially progress to renal failure. Therefore, to treat and protect kidney function, it is advised that patients with diabetic nephropathy seek care in the nephrology department of a formal public hospital, where nephrologists can devise a more reasonable treatment plan.

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Written by Zhou Qi
Nephrology
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Treatment of Anemia in Diabetic Nephropathy

Compared to primary chronic nephritis, patients with diabetic nephropathy develop anemia earlier and more severely. The treatment for this type of anemia is divided into two aspects. Firstly, since it is anemia caused by renal lesions leading to a lack of erythropoietin, it is necessary to supplement erythropoietin, as well as iron and folic acid, which are raw materials for blood production, for the anemia caused by diabetic nephropathy. Additionally, patients with diabetic nephropathy are prone to malnutrition and should enhance nutritional support, especially by increasing the intake of high-quality animal protein.

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Written by Pan Wu Shan
Nephrology
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What foods should be eaten for diabetic nephropathy?

Diabetic nephropathy is essentially a complication of the kidneys caused by diabetes, characterized by a history of diabetes for at least five to ten years, with very poor blood sugar control, leading to diabetic nephropathy. The main clinical manifestation is a large amount of proteinuria. Typically, patients will have a large amount of urinary protein, even exceeding 3.5 grams, and some patients may also experience swelling in the lower limbs, among other symptoms. Currently, dietary considerations for diabetic nephropathy mainly include a low-salt, low-fat, high-quality protein diet, and a diabetic diet. Avoid eating foods high in starch, such as potatoes, peanuts, Chinese yam, taro, etc., and also avoid foods high in sugar. Cucumbers, bitter melon, celery, and tomatoes are all good options to consider.

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Written by Zhou Qi
Nephrology
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Can diabetic nephropathy cause blood in urine?

Generally speaking, diabetic nephropathy does not cause hematuria. The main site of damage in diabetic nephropathy is indeed the glomerulus. Prolonged hyperglycemia and metabolic disorders can lead to damage to the capillaries of the glomerulus. However, the main clinical characteristic of this damage is proteinuria, which causes glomerulosclerosis and may also lead to renal failure, but it is rare for patients to have red blood cells in their urine or to experience hematuria. Therefore, if a patient with diabetic nephropathy has visible hematuria, such as red or tea-colored urine, it is necessary to check for other causes beyond diabetes, such as urinary tract infections, urogenital system stones, tumors, etc., all of which can cause hematuria.