Symptoms of stage 2 diabetic nephropathy

Written by Zhou Qi
Nephrology
Updated on January 10, 2025
00:00
00:00

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.

Other Voices

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

How is diabetic nephropathy diagnosed?

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
55sec home-news-image

How to check for diabetic nephropathy?

For the examination of diabetic nephropathy, patients first need to undergo routine urinalysis and check for the urinary albumin excretion rate. Generally speaking, one characteristic of diabetic nephropathy is the presence of urinary protein. A urinary albumin excretion rate between 20 and 200 µg/min is an important basis for diagnosing early diabetic nephropathy. If a patient’s urinary albumin excretion rate consistently exceeds 200 µg/min, significant diabetic nephropathy is often considered. Of course, this is under the assumption that the patient has had diabetes for at least ten years and has diabetic retinopathy. A kidney biopsy is needed for confirmation. Of course, to assess the impact of diabetic nephropathy on kidney function, blood tests for serum creatinine and urea nitrogen are necessary.

doctor image
home-news-image
Written by Hu Lin
Nephrology
1min 58sec home-news-image

How to prevent and treat diabetic nephropathy

The prevention and treatment of diabetic nephropathy include the following 6 aspects: The first is changing lifestyle, including controlling weight, diabetic diet, quitting smoking, quitting alcohol, and appropriate exercise. Changing lifestyle is the foundation of blood sugar control and a key to improving various metabolic disorders. The second is blood sugar control. Strict blood sugar control is the most important means to prevent the occurrence and development of diabetes and diabetic nephropathy. Under normal kidney function, it is recommended to keep glycated hemoglobin below 6.2%. For patients with abnormal kidney function or elderly patients, it can be relaxed to 7%. The third is to reduce blood pressure and proteinuria. The most commonly used medications are ACE inhibitors and angiotensin receptor blockers. Once diabetic microalbuminuria appears, blood pressure should be controlled below 130/80 mmHg. The fourth is to restrict the intake of dietary protein, with a focus on animal protein, i.e., high-quality protein. Early stage protein intake should be controlled at 0.8-1g/kg; for patients who have developed renal failure, controlling protein intake at 0.6-0.8g/kg is more appropriate. The fifth involves controlling other factors, including a low-salt diet and treating hyperlipidemia. The sixth is the treatment of end-stage diabetic nephropathy. Since diabetic nephropathy patients frequently have cardiovascular complications and symptoms of uremia appear earlier, it is appropriate to start dialysis treatment early. (Please take medications under the guidance of a doctor.)

doctor image
home-news-image
Written by Pan Wu Shan
Nephrology
1min 7sec home-news-image

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
1min 5sec home-news-image

How should diabetic nephropathy patients drink water?

For any kidney disease, regardless of whether it is caused by diabetes or not, the patient's water intake needs to be carefully considered. Generally, a few key points should be adhered to: First, there should be no excess accumulation of water in the patient's body. The water intake should be excreted normally through the kidneys without accumulating too much water, as excessive accumulation can increase blood pressure and even lead to pulmonary edema or heart failure. Second, if the patient's urine output decreases, water intake should be limited but not excessively, to avoid affecting the blood supply to the kidneys. Ideally, urine output should be maintained between 1000 to 2500 milliliters. Water intake should depend on urine output; if urine output is high, the patient can drink more water, but if it is low, intake should be appropriately restricted. It's necessary to weigh oneself daily to monitor changes in weight; if a large amount of water accumulates, weight will gradually increase, and at this time, water intake should be restricted.