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What Is Diabetic Nephropathy

Diabetic Nephropathy is one of the life-threatening complication of Diabetes. It occurs easily when one lives with Diabetes for 5 to 10 years. Diabetic Nephropathy progresses if high blood sugar and affected kidney damages can not be controlled effectively. So far Diabetic Nephropathy has become the leading two causes of End Stage Renal Disease (ESRD) and once kidney failure is caused, it is extremely hard to get impaired kidney condition improved.

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Tests and Diagnosis of Diabetic Nephropathy

Early stage Diabetic Nephropathy is relatively easy to control, but the problem is many diabetic do not know their kidneys are involved until their kidney problem develops to a severe condition. For this reason, a regular test is very essential for diabetics to have a close observation about their kidneys. To diagnose Diabetic Nephropathy, the following tests are suggested:

Blood test: Through blood test, diabetics can know well about their GFR(Glomerular Filtration Rate) which reflects how well the kidney function. In early stage of Diabetic Nephropathy, GFR becomes slightly higher than the normal range and when kidney function is impaired seriously, GFR decreases quickly. Also, with blood test, you can know your serum creatinine level which also helps to reflect how well the kidney is working.

Microalbumin urine test: When kidney is damaged, albumin will leak into urine. Microalbuminuria is the typical symptom of Diabetic Nephropathy. For patients with Diabetes, when there is detected with albumin in their urine, they should be alert about their kidney.

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How Is Diabetic Nephropathy Caused

Diabetic Nephropathy is secondary to Diabetes which is a illness marked by persistent high blood sugar. Without timely control, blood sugar becomes extremely high. Kidneys are responsible for filtering blood. When blood pass through kidney, excess blood sugar are expelled out with urine. It is ok for kidney to bear a heavy burden. However, if this condition lasts for a long time, kidney tissues are injured easily due to the long-term overwork. Besides, clinical studies show that long-term high blood sugar can cause disturbance of carbohydrate metabolism in the kidney, which may damage kidney and impair kidney function.

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5 Stages of Diabetic Nephropathy

Diabetic Nephropathy is caused when kidney function is affected due to years of Diabetes. In medicine, Diabetic Nephropathy is divided into 5 stages according to the pathological changes:

Stage 1 Diabetic Nephropathy : in stage 1, there is no obvious pathological changes and also on symptoms are caused.

Stage 2 Diabetic Nephropathy: stage 2 is marked by increased GFR and thickness of Glomerular Basement Membrane. For patients to stage 2 Diabetic Nephropathy, their urinary albumin excretion rate increases after drastic exercises, which means excess protein can be found in their urine after they do physical exercises. Besides, if blood sugar can be controlled well in this stage, further kidney damages can be avoided effectively.

Stage 3 Diabetic Nephropathy: GFR begins to decreases when Diabetic Nephropathy develops to stage 3.

Stage 4 Diabetic Nephropathy: Once Diabetic Nephropathy develops to stage 4, illness condition becomes hard to be controlled. In this stage, GFR keeps decrease at the rate of 1ml/min per month if no effective treatment is given.

Stage 5 Diabetic Nephropathy: Dialysis or kidney transplant is suggested when illness condition progresses to stage 5.

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Signs and Symptoms of Diabetic Nephropathy

Throughout its early course, Diabetic Nephropathy has no symptoms. However, without enough attention and effective treatment, kidney condition becomes poorer and poorer. In that case, the following symptoms will appear one by one:

Edema/swelling: Edema occurs easily around the eyelid, in the face, inside the ankle and even the whole body in advanced stage.

High blood pressure/hypertension

Foamy urine: Foamy urine is the manifestation of proteinuria which refers to excess protein in urine.

Unintentional weight gain from fluid accumulation.

Poor appetite occurs when digestive tract is affected by high levels of toxins which should be expelled by kidney. Also, nausea and vomiting can be caused if these harmful substances can not be removed effectively and timely.

Tiredness or fatigue: this may occur as a consequence of renal anemia which is diagnosed when there are excess red blood cells in urine.

Sleep problems

Skin problems like yellow skin, dry skin and itchy skin

Deep breath and shortness of breath

Diabetes is an illness which not only damage kidney, but also many other organs like eyes, feet and nerves. For people with Diabetic Nephropathy caused by years of uncontrolled high blood sugar, apart from the above systems, they also run extremely risk for diabetic retinopathy, diabetic foot and diabetic neuropathy and so on.

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Treatment Principle for Diabetic Nephropathy

Treatment for Diabetic Nephropathy depends on the specific illness condition. In medicine, the following methods are usually taken to treat Diabetic Nephropathy.

1. Tight control of high blood sugar

For people with Diabetic Nephropathy, their HbA1c should be controlled below 7.0%. Tight control of blood sugar helps to remit proteinuria symptoms and slow down illness condition.

2. Treatment for high blood pressure

When blood pressure is elevated due to kidney damages, ACE inhibitors or ARB can be applied to lower blood pressure. Also, these medicines show effects in reducing protein in urine.

3. Micro-Chinese Medicine Osmotherapy for kidney damages

Micro-Chinese Medicine Osmotherapy can be applied when kidney tissues are damaged. Micro-Chinese medicine is based on Chinese herbs and effective ingredients in this medicine has been proven to be able to activate injured kidney intrinsic cells to help them perform function again.

4. Reasonable diet plan

High protein intake increase kidney burden, so protein intake should be limited. In early stage, 0..6-0.8grams of protein per kilogram of body weight is needed per day. However, when illness condition deteriorates to severe stage, 0.4 grams of protein per kilogram of body weight is suggested per day. Besides, for Diabetic Nephropathy patients, if they have started dialysis, much more protein will needed ( usually 1.0-1.2grams of protein per kilogram of body weight per day), as at that time, they need to replenish the protein that are lost from urine and dialysis.

5. Dialysis or kidney transplant will be required when kidneys are completely failed due to Diabetic Nephropathy

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What Foods to Eat and Not to Eat with Diabetic Nephropathy

For Diabetic Nephropathy patients, foods they choose must be:

1. Low in sugar

In our daily life, many foods, especially some fruits, are high in sugar. With Diabetes, patients need to stay far away from these foods, so as to control their blood sugar easily and strictly.

2. Low in protein

High protein diet is harmful, as it increase kidney burden and cause further kidney damages. For this reason, limiting protein intake is very essential. Besides, some high quality protein like egg white, fish and lean meat are suggested, as they can supply patients’ body with necessary amino acid.

3. Low in salt

Salt is high in sodium. Kidneys are responsible for discharging excess sodium in blood, so high salt diet will increase kidney burden, which is not beneficial for kidney. Besides, high salt diet also elevates blood pressure and triggers swelling. From this point of view, low salt diet is necessary.

4. Low is fat

Diabetic Nephropathy patients are easily attacked by hyperlipemia. For this reason, greasy foods should not be put in dinner table often.

5. Low in potassium and phosphorus if there are elevated potassium and phosphorus level in blood.

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