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Diabetic nephropathy in different stages of diabetic nephro

2017-03-02 13:53

Diabetic nephropathy is a complication of diabetes, we need to take a good look at it, to deal with the disease or to a good treatment, otherwise not get the. The following is a small series of diabetic nephropathy for all of the relevant content, we may wish to look at, or quite good. Well, here's a small series for everyone to introduce it.

Diabetic nephropathy stage

Diabetic nephropathy is a systemic microvascular disease complications of diabetic nephropathy, therefore also often combined with other organs or systems of microvascular diseases such as diabetic retinopathy and peripheral neuropathy. Type 1 diabetic patients with diabetic nephropathy in the onset of 10-15 years or so, and type 2 diabetic patients with diabetic nephropathy time is short, with the age, while more than other basic diseases.

According to the course of disease and pathophysiology of diabetic nephropathy, Mogensen has suggested that diabetic nephropathy is pided into the following five stages:

1 glomerular filtration and renal hypertrophy

This initial change is consistent with high blood glucose levels, which can be partially alleviated after glycemic control. No histopathological lesions were present.

2 normal albuminuria period

GFR higher than normal. Renal pathology showed GBM thickening, mesangial matrix increased, urinary albumin excretion rate (UAE) increased after exercise (>20 g/min), and recovered after rest. If you can control blood glucose well during this period, the patient can be stable for a long time.

3 in the early stage of diabetic nephropathy, also known as "continuous microalbuminuria"

GFR began to drop to normal. Renal pathological changes in glomerular nodular lesions and small artery hyaline degeneration. UAE continued to rise from 20 to 200 g/min, resulting in microalbuminuria. Blood pressure increased in this period. Treatment with ACEI or ARB can reduce urinary albumin excretion and delay the progression of renal disease.

4 clinical diabetic nephropathy

Pathologically, there are typical K-W nodules. Persistent massive albuminuria (UAE>200 g/min) or proteinuria is greater than 500mg/d, about 30% of patients with nephrotic syndrome, GFR continued to decline. This period is characterized by urinary protein does not decrease with the decrease of GFR. Once the patient into the IV period, the disease is often sexual development, if not actively controlled, GFR will average monthly decline of 1ml/min.

5 end stage renal failure

GFR<10ml/min. The amount of urine protein decreased due to glomerular sclerosis. Symptoms of uremia, dialysis treatment.

These stages are mainly based on type 1 diabetic nephropathy, type 2 diabetic nephropathy is not obvious.

Proteinuria is closely related to the progression of diabetic nephropathy. Microalbuminuria is not only an indication of glomerular filtration barrier, but also a systemic vascular endothelial dysfunction and is associated with cardiovascular complications.

Compared with the common primary glomerular disease, the degree of edema of diabetic nephropathy is more obvious, and is often accompanied by severe hypertension. Due to the high glomerular capillary pressure and glomerular filtration membrane barrier function, the patients with end-stage renal failure may also have a lot of proteinuria.

 

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