Is diabetic nephropathy stage 3 reversible?

Written by Zhou Qi
Nephrology
Updated on November 06, 2024
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Patients with diabetic nephropathy actually have an irreversible condition. If a patient has developed mild to moderate proteinuria and entered stage three, it's generally because of long-term high blood sugar, oxidative stress, and an excess of glycation end products damaging the capillaries of the glomerulus, resulting in increased permeability and the occurrence of proteinuria. The damage that has already occurred cannot be reversed; however, patients still need active treatment to control their blood sugar and blood pressure in order to slow down the progression of diabetic nephropathy as much as possible. Stage three diabetic nephropathy is incurable, but treatment can slow the progression of the kidney disease, preventing the development from microalbuminuria to macroalbuminuria. Stage three refers to the early period of diabetic nephropathy, typically seen in diabetic patients who have had the disease for more than five years. It can feature a continuous increase in urinary albumin excretion rates. High filtration rates and long-term poor metabolic control may be reasons for the persistent microalbuminuria. During this stage, patients may experience a mild increase in blood pressure, and reducing blood pressure can decrease the excretion of microalbumin. During this period, strict control of blood sugar is necessary. Oral hypoglycemic drugs can be used for treatment, and it's crucial to regularly monitor fasting blood glucose, postprandial blood glucose, and glycated hemoglobin. Blood pressure should also be actively controlled, generally targeting a value of 130/80mmHg. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists are preferred as they can lower blood pressure, reduce proteinuria, and have a protective effect on the kidneys, thus delaying the progression of kidney disease.

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Written by Zhou Qi
Nephrology
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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.

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Written by Zhou Qi
Nephrology
2min 2sec home-news-image

Is diabetic nephropathy stage 3 reversible?

Patients with diabetic nephropathy actually have an irreversible condition. If a patient has developed mild to moderate proteinuria and entered stage three, it's generally because of long-term high blood sugar, oxidative stress, and an excess of glycation end products damaging the capillaries of the glomerulus, resulting in increased permeability and the occurrence of proteinuria. The damage that has already occurred cannot be reversed; however, patients still need active treatment to control their blood sugar and blood pressure in order to slow down the progression of diabetic nephropathy as much as possible. Stage three diabetic nephropathy is incurable, but treatment can slow the progression of the kidney disease, preventing the development from microalbuminuria to macroalbuminuria. Stage three refers to the early period of diabetic nephropathy, typically seen in diabetic patients who have had the disease for more than five years. It can feature a continuous increase in urinary albumin excretion rates. High filtration rates and long-term poor metabolic control may be reasons for the persistent microalbuminuria. During this stage, patients may experience a mild increase in blood pressure, and reducing blood pressure can decrease the excretion of microalbumin. During this period, strict control of blood sugar is necessary. Oral hypoglycemic drugs can be used for treatment, and it's crucial to regularly monitor fasting blood glucose, postprandial blood glucose, and glycated hemoglobin. Blood pressure should also be actively controlled, generally targeting a value of 130/80mmHg. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists are preferred as they can lower blood pressure, reduce proteinuria, and have a protective effect on the kidneys, thus delaying the progression of kidney disease.

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Written by Zhou Qi
Nephrology
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Is diabetic nephropathy dialysis painful?

Whether it is diabetes, nephritis, high blood pressure, or other causes leading to kidney failure, it may eventually progress to uremia. Patients with such conditions need dialysis or a kidney transplant to survive. Generally, patients undergoing any type of dialysis do not experience significant pain symptoms. Dialysis can be divided into hemodialysis and peritoneal dialysis, both of which use artificial methods to remove metabolic waste from the patient's body and maintain the stability of the internal environment. These methods generally do not involve significant traumatic procedures, so they mostly do not cause notable pain. However, patients undergoing hemodialysis may need temporary needling each time, which causes minimal trauma and typically does not result in severe pain or significant discomfort.

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Written by Zhou Qi
Nephrology
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Can diabetic nephropathy patients eat kelp?

Patients with diabetic nephropathy should avoid eating seafood, including various types of sea fish, shellfish, as well as seaweed, kelp, and so on. This is because these seafood products contain a certain amount of purines, and some foods have a high purine content. When purines enter the human body, they are metabolized and eventually converted into uric acid, which needs to be excreted by the kidneys. Patients with kidney disease have decreased ability to excrete uric acid, and the accumulation of uric acid may cause further damage to the kidneys and also affect the cardiovascular and cerebrovascular systems. Therefore, generally speaking, it is advised that patients with diabetic nephropathy should avoid eating kelp. However, if the patient’s condition is in the early stages and kidney function is still normal, consuming some kelp in moderation generally should not be a problem, but it should not be consumed in large amounts.

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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.