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What are the treatment methods for diabetic nephrosis?

2017-07-19 16:41

Active controlling of hypertension

When the urine protein is negative or less than 1 grams /24 hours, the target value of blood pressure control should be below 130/80mmHg. Patients with urinary protein levels higher than or equal to 1 g /24 h, preferably blood pressure for them is below 125/75mmHg; reducing complications of diabetics, particularly the controlling of progressing of diabetic nephropathy are very important. The preferred antihypertensive drugs are ACEI and ARB drugs.

Low protein diet

When the glomerular filtration rate decreased, the dietary protein intake was 0.6g/kg/d. Animal protein is preferred, avoid crude protein, such as soy protein. In the implementation of low protein diet treatment, people need to prevent malnutrition. The key to preventing malnutrition is to ensure that the patient has enough calories and can take the compound a- keto acid.

Strengthening diabetes treatment

Strictly controlling blood sugar and keeping blood sugar close to the normal level can reduce the incidence of microalbuminuria and slow down the process of nephropathy. After the occurrence of renal dysfunction, the hypoglycemic drugs have special requirements.

(1) insulin: need to adjust insulin dosage;

(2) oral hypoglycemic agents: after the occurrence of renal dysfunction, oral hypoglycemic drugs metabolism in vivo change; drugs should be selected and differentiated in treatment:

Sulfonylureas. It mainly excreted through kidney; kidney dysfunction patients may get accumulation of drugs in vivo which easily induce hypoglycemia; so it should be restricted with these patients. But only 5% of Gliquidone metabolites excreted by the kidneys, so mild to moderate renal insufficiency patiengs can still use this drug. Double guanidine drugs. These drugs are mainly excreted through the kidneys, when the kidney fails, the accumulation of drugs in the body easily lead to severe lactic acidosis, it is prohibited. Only 1% to 2% of the a-glucosidase inhibitor is absorbed into blood after oral administration; and the rest can be discharged through the intestine and this drug can be taken when the kidney fails. Thiazolidinediones and two ketones can be used in mild or moderate renal insufficiency. Nateglinide can be used in mild or moderate renal insufficiency.

4. other treatments

People with edema and hypertension limit sodium intake, ban smoking, limit alcohol consumption, lose weight and take proper exercise, regulate blood lipids, and treat anticoagulation.

5. end stage

Hemodialysis, peritoneal dialysis and renal transplantation are effective treatments for renal failure.

What are the treatment methods for diabetic nephrosis

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