How To Detect Diabetic Nephropathy Early?

Diabetic nephropathy refers to kidney damage caused by diabetes itself. Clinically, persistent proteinuria is the main sign, that is, persistent albuminuria > 200 μg/min or 300 mg/24 hours, usually accompanied by diabetic retinopathy.

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Diabetic nephropathy occurs in about 20% to 40% of patients with diabetes. The incidence of nephropathy in patients with type 1 diabetes is related to the course of diabetes. The incidence of nephropathy in patients with a course of 20 to 25 years is 40% to 50%; the incidence of nephropathy in patients with type 2 diabetes is about 20% to 50%.

If you enter the middle and late stages of renal failure, you may gradually develop symptoms of uremia. Diabetic nephropathy is one of the important causes of diabetes disability and death. In developed countries in Europe and the United States, the proportion of diabetic patients in dialysis patients has already surpassed that of nephritis.

The situation in China is not optimistic. Although the proportion of diabetic patients is lower than that of nephritis, the proportion is still rising; the main reason is that the prevalence of diabetes in my country is constantly increasing, and the control efforts are far apart.

The damage of diabetes to the kidney is mainly due to the damage of high blood sugar to the glomerulus and renal blood vessels. There are about 1 million glomeruli in the human kidney, and each glomerulus is a group of tiny arteries. Long-term high blood sugar can gradually cause glomerulus sclerosis.

High blood sugar can also damage the renal arteries, and long-term high blood sugar can lead to renal arteriosclerosis and even stenosis, followed by decreased kidney function.

Diabetic nephropathy is a chronic process. Its early clinical symptoms are often not obvious, and microalbuminuria (urinary albumin excretion rate is 20-200 μg/min, or 30-300 mg/hour) can often appear; in the clinical nephropathy stage, urinary albumin excretion rate exceeds 200 Micrograms/min, or 300 mg/24 hours, or total urine protein over 0.5 g/24 hours. About 10% of patients with diabetic nephropathy clinically present with nephrotic syndrome, urinary protein excretion rate > 3.5 g/24 hours, decreased serum albumin and may be accompanied by edema.

The prevalence of chronic complications of diabetes is high and harmful, so we must pay great attention to its prevention and treatment, the key lies in early prevention and comprehensive prevention and treatment. First of all, we should pay attention to early prevention and treatment. Diabetic patients should regularly check their urine routine and urinary albumin excretion rate, especially for patients with a history of diabetes for more than 5 years, at least 2 or more times a year should be monitored.

Controlling the patient's blood sugar is the basic measure to prevent and delay various chronic complications of diabetes. Blood sugar must reach the standard, that is, fasting blood sugar level <140mg/dl (7.8mmol/l), 2 hours after meal blood sugar level <180mg/dl (10.08mmol/l), glycosylated hemoglobin drops below 7.0%; if some patients fasting blood sugar level <110mg/dl (6.1mmol/l), 2-hour postprandial blood glucose level <140mg/dl (7.8mmol/l), glycosylated hemoglobin drops below 6.5%, it is more satisfactory.

At the same time, comprehensive prevention and control should be emphasized. It mainly includes the following aspects: improving lifestyle, actively controlling hyperglycemia, hypertension, proteinuria, hyperlipidemia, hyperuricemia, high body mass index (obesity or overweight), and reducing microvascular disease, etc. Urinary microalbumin must be checked regularly to detect kidney damage as early as possible and treat it as soon as possible. People with hypertension should actively control their blood pressure to ensure that the blood pressure reaches the standard.