How to supplement for anemia in diabetic nephropathy?

Written by Zhou Qi
Nephrology
Updated on September 04, 2024
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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.)

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Written by Zhou Qi
Nephrology
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How many years can a person with diabetic nephropathy live?

Diabetic nephropathy is divided into several stages, from mild to severe. In the early stage, patients only have an increased glomerular filtration rate and the proteinuria is not significant. As the disease progresses, the protein in the urine increases, eventually leading to renal failure and even developing into uremia. The entire process can last many years, with some patients experiencing it for up to ten years. In fact, when diabetic nephropathy progresses to its final stage, uremia, patients still have many treatment options, such as hemodialysis, peritoneal dialysis, or kidney transplantation, and even combined kidney and pancreas transplantation. Therefore, how long a patient can live depends on the patient's age, presence of cardiovascular and cerebrovascular diseases, and the choice of treatment methods, among other factors.

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Written by Zhou Qi
Nephrology
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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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Written by Zhou Qi
Nephrology
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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.)

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Written by Zhou Qi
Nephrology
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Early signs of diabetic nephropathy

Diabetic nephropathy is caused by long-term diabetes leading to damage in the small blood vessels. Generally, patients have a history of diabetes for over ten years. Diabetic nephropathy progresses through several stages. In the early stages, patients primarily exhibit microalbuminuria. Due to the presence of protein in the urine, patients may experience increased urine foam, especially noticeable with morning urination. Some patients may develop swelling in the lower limbs and around the eyelids. As the condition progresses, the amount of urine protein increases and the swelling becomes more pronounced, potentially reaching the level of nephrotic syndrome.

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Written by Li Liu Sheng
Nephrology
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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.