How is diabetic nephropathy diagnosed?

Written by Zhou Qi
Nephrology
Updated on September 01, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Zhou Qi
Nephrology
1min 1sec home-news-image

How to reduce proteinuria in diabetic nephropathy.

A major clinical feature of diabetic nephropathy is the occurrence of proteinuria, which, if the condition continues to progress, can lead to kidney failure. Controlling proteinuria in the early stages of the disease is indeed very important. In terms of treatment, it is primarily necessary to use medications or insulin to control the patient's blood sugar, as hyperglycemia is the fundamental cause of diabetic nephropathy. Additionally, these patients often also have hypertension, necessitating the use of antihypertensive drugs to control blood pressure. When the patient's kidney function is not severely impaired, ACE inhibitors or ARBs can be the preferred choice of antihypertensive drugs, as they not only control blood pressure but also reduce proteinuria. However, if the patient's serum creatinine is significantly elevated, such as over 264 µmol/L, these drugs should no longer be used. (Medications should be used under the guidance of a doctor.)

doctor image
home-news-image
Written by Zhou Qi
Nephrology
57sec home-news-image

Which department should diabetic nephropathy patients see?

Diabetic nephropathy is damage to small blood vessels caused by diabetes, and the kidneys contain a large number of small blood vessels. Therefore, it generally takes more than ten years for diabetes to damage these small blood vessels, causing kidney lesions, proteinuria, renal failure, and other clinical manifestations. This disease can be treated in departments specializing in diabetes or endocrinology, as well as in nephrology. In the early stages of diabetic nephropathy, treatment primarily involves controlling blood sugar levels, and visiting departments like diabetes or endocrinology might be more specialized in this regard. These departments are proficient in adjusting medications for blood sugar control. When patients develop significant proteinuria, the condition progresses, and it is advisable to visit nephrology. At this point, the treatment focuses on the kidney lesions, as well as managing complications caused by diabetic nephropathy.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
2min 2sec home-news-image

Is diabetic nephropathy stage 3 reversible?

Patients with diabetic nephropathy actually have an irreversible condition. If a patient has developed mild to moderate proteinuria and entered stage three, it's generally because of long-term high blood sugar, oxidative stress, and an excess of glycation end products damaging the capillaries of the glomerulus, resulting in increased permeability and the occurrence of proteinuria. The damage that has already occurred cannot be reversed; however, patients still need active treatment to control their blood sugar and blood pressure in order to slow down the progression of diabetic nephropathy as much as possible. Stage three diabetic nephropathy is incurable, but treatment can slow the progression of the kidney disease, preventing the development from microalbuminuria to macroalbuminuria. Stage three refers to the early period of diabetic nephropathy, typically seen in diabetic patients who have had the disease for more than five years. It can feature a continuous increase in urinary albumin excretion rates. High filtration rates and long-term poor metabolic control may be reasons for the persistent microalbuminuria. During this stage, patients may experience a mild increase in blood pressure, and reducing blood pressure can decrease the excretion of microalbumin. During this period, strict control of blood sugar is necessary. Oral hypoglycemic drugs can be used for treatment, and it's crucial to regularly monitor fasting blood glucose, postprandial blood glucose, and glycated hemoglobin. Blood pressure should also be actively controlled, generally targeting a value of 130/80mmHg. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists are preferred as they can lower blood pressure, reduce proteinuria, and have a protective effect on the kidneys, thus delaying the progression of kidney disease.

doctor image
home-news-image
Written by Li Liu Sheng
Nephrology
56sec home-news-image

Which department to see for diabetic nephropathy

Diabetic nephropathy is a kidney disease caused by diabetes. The main clinical manifestations of diabetic nephropathy usually include varying degrees of increased urine protein. Severe cases may also present with lower limb edema and reduced kidney function. As for which department to consult for diabetic nephropathy, it depends on the severity of the condition. In the early stages of diabetic nephropathy, if there is only a slight increase in urine protein and the chronic kidney disease is at stage one or two, patients can choose to see a specialist in the endocrinology department for diabetic nephropathy. Once the condition of diabetic nephropathy worsens, progressing to stage three or above of chronic kidney disease, and the patient also has significant increases in urine protein, decline in kidney function, and the onset of anemia, it is advisable to seek treatment in a nephrology department.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
47sec home-news-image

How to supplement for anemia in diabetic nephropathy?

Patients with diabetic nephropathy who exhibit anemia are often in a state of chronic renal failure. This anemia caused by chronic kidney disease is mainly due to the decreased secretion of erythropoietin by the kidneys. Therefore, treatment involves the use of erythropoietin to stimulate bone marrow hematopoiesis. In addition to this medication, patients generally also need to supplement with iron preparations, such as ferrous succinate, sucrose iron, etc., and take oral folic acid, all of which are raw materials for blood formation. Furthermore, if patients have severe malnutrition, they should also supplement with foods rich in protein, such as eggs, milk, chicken, duck, fish, etc. (Please use medications under the guidance of a doctor.)