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Diabetic nephropathy and renal failure

2016-12-30 09:10
With the improvement of living standards, the incidence of diabetes is increasing. Diabetes can cause kidney damage. Duration of diabetes in patients with 10-20, regardless of age, have more than half of proteinuria. With the aggravation of proteinuria, edema, hypertension, and renal failure may occur. The study found that, regardless of type 1 or type 2 diabetes, the kidney glomerular sclerosis with tubular vacuolar degeneration and renal afferent and efferent arteriolar sclerosis and other more specific changes. The severity of the disease was parallel to the course of diabetes, and almost all of the patients had 15-20 after the onset of diabetes. Therefore, the specific characteristics of this type of diabetes in patients with diabetic nephropathy, glomerulosclerosis and renal tubular disease.
In order to make diabetic nephropathy patients have a deeper understanding of the disease, to understand the occurrence and development of the disease, and how to effectively control and prevention, improve the quality of life of patients with diabetic nephropathy.
At present, the mechanism of diabetes induced renal damage is still unclear. But generally, long-term high blood sugar into the cells to promote the enzyme activity was increased, which led to the formation of enzymes and protein complexes deposited in glomeruli and glomeruli were seriously damaged; on the other hand, due to high blood sugar, biochemical composition caused by abnormal glomerular, increase vascular permeability, plasma protein leakage involved in the formation of glomerular sclerosis. The levels of growth hormone in the plasma of young diabetic patients are high, and the formation of the complex of sugar and protein is involved in the formation of sugar and protein. Renal tubular degeneration and afferent efferent arteriolar sclerosis, and hyperglycemia has a direct relationship. In addition, diabetic patients are prone to secondary infection, recurrent severe urinary tract infection can cause renal cortical necrosis. According to current knowledge, diabetes is not only because of kidney damage caused by hyperglycemia, but a complex process and sugar protein fat metabolism abnormal blood coagulation and blood stasis genetic defects, endocrine disorders and related factors. Early diabetic kidney damage, to conceal, as the disease is lengthened, glomerular sclerosis condition is more obvious, more and more glomerular involvement, more later development faster, eventually leading to proteinuria and other symptoms, and ultimately progress to renal failure.
Reporter: according to the survey: 10 years of diabetes patients and in the past 20 years there will be more than 50% of people appear albuminuria, had no other feeling?
Xu Dean: clinical observation of diabetic nephropathy in the first phase and the second phase of the laboratory examination is no problem, the patient did not feel, only a small number of patients with high blood pressure sometimes. So it is still at the stage of diabetes patients in a timely manner through the examination is also difficult to know that they have been suffering from kidney disease, in a timely manner, the symptoms of blood pressure is also difficult to relate to the early symptoms of kidney disease.
In the third phase of the patient has had some clinical manifestations, urine protein began to appear, blood pressure also began to rise, an important measure of urinary trace protein has been higher than 20 micrograms / ml. In general the patient just have some symptoms, is still in the early stage of nephropathy, this is an important point of diabetic nephropathy can recover completely, hold there is the possibility of recovery, can not grasp the condition will continue to deteriorate.
The diagnostic criteria of fourth sugar, the emergence of a large number of protein in patients with diabetic nephropathy in the urine, blood pressure still continues to rise, the standard for protein more than 200 mg / ml, there can be swelling and other clinical manifestations, renal functional decline. At this point the focus of treatment is how to control the disease to prevent the development of uremia.
The fifth stage is end-stage renal disease, the clinical manifestations of elevated blood pressure with edema, creatinine and urea nitrogen increased. This term is usually treated with regular dialysis or kidney transplantation
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