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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Can people with diabetic nephropathy drink alcohol?

Diabetic nephropathy, as the name suggests, is a complication caused by diabetes that leads to kidney problems. The typical symptoms of diabetic nephropathy are significant proteinuria and hypoalbuminemia. Generally speaking, there is no particularly effective treatment for diabetic nephropathy; it can only be managed by keeping blood sugar and blood pressure under control. For patients with diabetic nephropathy, it is recommended to keep fasting blood glucose below 7, and postprandial glucose should be controlled between 8 and 10, which is considered appropriate. If hypertension is present, blood pressure should be kept below 140/80 mmHg. In terms of diet, patients with diabetic nephropathy definitely should not drink alcohol, and they should avoid sweets, fried foods, and foods high in starch. It is also important not to stay up late.

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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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Can diabetic nephropathy with swollen feet be treated?

Diabetic nephropathy in the middle and later stages can cause edema, especially in patients with significant proteinuria or renal failure. Many patients can even experience generalized edema. For such patients, swollen feet and swelling in other parts of the body can be considered for appropriate use of diuretics to increase urine output and eliminate edema. However, generally, the extensive use of diuretics is not actively advocated because excessive diuresis can also lead to significant protein loss and even cause insufficient blood volume, affecting the blood supply to the kidneys. Nevertheless, some patients with severe conditions that cause pulmonary edema and heart failure may not respond well to diuretics. In such cases, dialysis ultrafiltration may be required to remove water, alleviate edema, and reduce cardiac stress.

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Late-stage symptoms of diabetic nephropathy

When patients with diabetic nephropathy reach the advanced stage, they actually already have severe renal failure. Prior to this, patients generally exhibit noticeable proteinuria. Continued progression of the disease will lead to the destruction of most of the renal tissues, causing renal failure. This condition is quite serious; patients often experience significant edema, even severe generalized edema. The accumulation of a large amount of fluid in the body leads to an increase in blood volume, and both the preload and afterload on the heart increase, often accompanied by symptoms of heart failure. When patients experience heart failure, they may find it impossible to lie flat and may experience chest tightness, shortness of breath, and difficulty breathing after activity, potentially endangering their lives.

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What can diabetic nephropathy eat?

Diabetic nephropathy, as the name suggests, is a complication of the kidneys caused by long-term poor control of blood sugar in diabetes. Its most typical symptoms include significant proteinuria and potential body edema. Generally, there is no particularly good method to treat diabetic nephropathy; firstly, it is necessary to control blood sugar well, ensuring that fasting blood glucose does not exceed 7 mmol/L, and blood glucose two hours after a meal does not exceed 10 mmol/L. Additionally, some kidney-protective measures can be used to reduce urinary protein, etc. Furthermore, foods high in sugar, fried foods, and those high in starch should be avoided, such as potatoes, taro, sweet potatoes, and vermicelli, all of which should be consumed less.