Which department to see for diabetic nephropathy?

Written by Zhou Qi
Nephrology
Updated on May 12, 2025
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In principle, patients with diabetic nephropathy should seek treatment in the nephrology department of a formal public hospital. Diabetes occurs when there is an absolute deficiency or relative insufficiency in insulin secretion, leading to a state characterized by high blood sugar and various metabolic waste disorders. Such a syndrome can cause damage to multiple organs. The kidneys are a major target organ for damage, and as kidney disease develops, patients may experience proteinuria and potentially progress to renal failure. Therefore, to treat and protect kidney function, it is advised that patients with diabetic nephropathy seek care in the nephrology department of a formal public hospital, where nephrologists can devise a more reasonable treatment plan.

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Written by Zhou Qi
Nephrology
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Can diabetic nephropathy cause blood in urine?

Generally speaking, diabetic nephropathy does not cause hematuria. The main site of damage in diabetic nephropathy is indeed the glomerulus. Prolonged hyperglycemia and metabolic disorders can lead to damage to the capillaries of the glomerulus. However, the main clinical characteristic of this damage is proteinuria, which causes glomerulosclerosis and may also lead to renal failure, but it is rare for patients to have red blood cells in their urine or to experience hematuria. Therefore, if a patient with diabetic nephropathy has visible hematuria, such as red or tea-colored urine, it is necessary to check for other causes beyond diabetes, such as urinary tract infections, urogenital system stones, tumors, etc., all of which can cause hematuria.

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Written by Zhou Qi
Nephrology
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Symptoms of stage four diabetic nephropathy

Stage four of diabetic nephropathy indicates the presence of significant amounts of urinary protein. At this stage, patients may exhibit symptoms of nephrotic syndrome, which means the total urinary protein quantification over 24 hours may exceed 3.5 grams, and the plasma albumin level may be lower than 30 grams per liter. Due to the large amount of protein leakage, patients may experience edema, presenting as swelling of the lower limbs or eyelids, or even severe generalized swelling. In addition to edema, patients may also have pleural and abdominal effusion, leading to pulmonary edema. Excessive fluid can overburden the heart, causing heart failure, which manifests as chest tightness, shortness of breath, and difficulty breathing, especially when the patient is active, these symptoms of chest tightness and shortness of breath become more pronounced.

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Written by Zhang Jun Jun
Endocrinology
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What should I do if diabetic nephropathy causes facial swelling?

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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Written by Zhou Qi
Nephrology
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Does diabetic nephropathy hurt?

Diabetic nephropathy generally does not cause painful symptoms. Diabetic nephropathy refers to the kidney damage that results from long-term diabetes, caused by factors such as hyperglycemia, oxidative stress, and an increase in advanced glycation end products. In the early stages, patients may experience an increase in kidney size and an increased glomerular filtration rate. As the condition progresses, proteinuria may occur, and it could eventually lead to severe renal failure. Throughout this process, patients typically do not experience pain because the kidneys do not have nerve innervation and therefore do not feel pain. Thus, including diabetic nephropathy, various kidney diseases and nephritis generally do not manifest with pain.

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Written by Zhou Qi
Nephrology
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Does diabetic nephropathy cause back pain?

Diabetic nephropathy generally does not cause symptoms of back pain. Diabetic nephropathy refers to patients with long-term hyperglycemia, typically those whose blood sugar has been elevated for ten years or more, causing damage to the small blood vessels. The kidneys, being rich in small blood vessels, undergo glomerular sclerosis. Early in the disease, patients experience an increased glomerular filtration rate. As the condition progresses, proteinuria gradually increases. When proteinuria occurs, patients may exhibit noticeable edema, and in some cases, patients may develop severe edema due to substantial proteinuria, leading to serious complications like pulmonary edema and heart failure, which manifest as respiratory difficulties and chest tightness. However, these conditions do not cause back pain, even though there is glomerular sclerosis, as patients do not feel any pain associated with it.