What should I do if diabetic nephropathy causes facial swelling?

Written by Zhang Jun Jun
Endocrinology
Updated on March 03, 2025
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Diabetic nephropathy with facial swelling is generally due to too much protein in the urine and too little protein in the blood, causing hypoalbuminemia, which leads to edema. There are several methods to control diabetic nephropathy: First, blood sugar and blood pressure must be strictly controlled within a normal range. Blood pressure control should be even stricter for those with diabetic nephropathy, generally kept below 130/80. Second, in terms of diet, it is crucial to avoid or limit intake of bean-based foods and consume high-quality proteins instead. High-quality proteins include commonly known meats, eggs, and fish. Third, it is essential to limit or avoid the use of medications that can damage the kidneys. Fourth, if diabetic nephropathy causes general body edema, intermittent use of diuretic medications can help alleviate the swelling, along with nephroprotective medications. The final method for severe kidney disease involves early intervention with hemodialysis or peritoneal dialysis. (Please use medications under the guidance of a doctor)

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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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Does diabetic nephropathy require a biopsy?

Whether a patient with diabetic nephropathy needs a biopsy depends on the condition of the patient. Firstly, if the kidney disease is in the early stages and the blood creatinine level has not exceeded 256 micromoles per liter, a kidney biopsy can be considered. Otherwise, if the blood creatinine level exceeds 256 micromoles per liter, a biopsy is no longer meaningful since significant fibrosis and hardening of kidney tissue have already occurred. At this point, if it is unclear whether the proteinuria is caused by diabetes or another disease, a kidney biopsy can be considered to diagnose the cause and extent of glomerular damage, and to provide a basis for treatment.

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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.)

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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.

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Symptoms of diabetic nephropathy anemia

Patients with diabetic nephropathy who exhibit anemia indicate that they are experiencing relatively severe renal failure. Such patients may show clear clinical symptoms, such as significant edema, excessive proteinuria, and renal failure. The impaired water excretion can lead to swelling in the lower limbs and facial area. The presence of anemia causes fatigue in patients, potentially leading to chronic ischemia and hypoxia in some organs. Symptoms such as listlessness and drowsiness may occur. In the state of anemia due to diabetic nephropathy, the accumulation of metabolic waste may also affect the patient's appetite, causing poor food intake. Additionally, diabetic damage to the retinal arteries can lead to a decline in vision, or even complete blindness.