How to prevent and treat diabetic nephropathy

Written by Hu Lin
Nephrology
Updated on October 27, 2024
00:00
00:00

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.)

Other Voices

doctor image
home-news-image
Written by Hu Lin
Nephrology
52sec home-news-image

Early symptoms of diabetic nephropathy

The early symptoms of diabetic nephropathy primarily include the presence of microalbuminuria, which is characterized by an albumin excretion rate of 30 to 300 mg per 24 hours, or a ratio of albumin to creatinine in spot urine ranging from 30 to 300 mg/g. However, this value needs to be tested three times over six months, with at least two of these tests meeting the above criteria for a diagnosis. Additionally, in the early stages of diabetes, patients' blood pressure tends to be within the normal range, but there is a trend toward elevation. Some patients may experience changes in the diurnal rhythm of their blood pressure, and the glomerular filtration rate may slightly increase or remain within the normal range.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
51sec home-news-image

How is diabetic nephropathy treated?

The treatment of diabetic nephropathy also depends on the specific stage the patient is in. During stages one to three, the main clinical treatments include controlling blood sugar, blood pressure, and lipids. Patients with diabetes often also have these metabolic disorders, including hypertension and hyperlipidemia, which can damage the kidneys. In addition, in the early stages, some medications are often chosen to reduce the pressure on the glomeruli. For example, using ACE inhibitors or angiotensin receptor blockers (ARBs) and inhibitors of the sodium-glucose cotransporter, these drugs can also slow the progression of kidney failure. However, if the patient's condition has progressed to stage five, which is essentially equivalent to the state of uremia, the patient will then need dialysis treatment.

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 Pan Wu Shan
Nephrology
1min 5sec home-news-image

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.

doctor image
home-news-image
Written by Luo Han Ying
Endocrinology
1min 7sec home-news-image

Is early diabetic nephropathy reversible?

Diabetic nephropathy clinically mainly manifests as an increase in urine protein on routine urine tests. Thus, diabetic nephropathy can be classified into different stages. In the early stages, microalbuminuria appears, and at this early phase, diabetic nephropathy is actually reversible. However, if the condition progresses with significant proteinuria, it becomes difficult to reverse diabetic nephropathy through intervention treatments. Most clinical patients may experience a slight reduction in urine protein or maintain this condition long-term without further progression. However, some patients have already experienced an increase in creatinine levels by the time they reach this stage of diabetic nephropathy, making it particularly challenging to reverse the condition once creatinine levels rise. Therefore, for diabetic nephropathy, early detection and treatment are crucial, with the most important goal being the prevention of the disease's onset.