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How to diagnose diabetic nephrosis?

2017-07-21 16:41

How to diagnose diabetic nephrosis? In recent years, diabetic nephropathy patients are becoming more and more; early treatment for diabetic nephropathy is very important; the most important phenomenon of early diabetic nephropathy is proteinuria, then how to distinguish that proteinuria is caused by kidney disease or by other illness is becoming very important. Here's a detailed introduction.

The most important phenomenon of early diabetic nephropathy is that the output of urinary albumin is slightly higher than that of normal people, called microalbuminuria; urinary albumin excretion is 0.02-0.2 g/ min or 30-300mg/24h or urinary albumin / creatinine (ACR 30-300mg/g). Once clinical proteinuria (proteinuria, >0, 5g/24h) occurs, the glomerular function is progressive decreasing and is irreversible. Diabetic kidney disease did not show any symptoms in early stage. The diagnosis may be confirmed in three ways. One way is to check body physical examination or taking checking due to own commercial insurance, and  go to the relevant physical examination institution finding albuminuria in urine check. Second way, it can be discovered by urine routine check conducted by endocrine doctor. The third route is that the patient get disease symptoms and then goes to the doctor, when is usually late, goes into the four or later stage of diabetic nephropathy. Diabetes prevention should be given priority to, take regular urine examination, early detection.

How to diagnose diabetic nephrosis? How to know that proteinuria is caused by kidney disease or by other diseases; the determination is sometimes difficult. There are some clinical practice guidelines for doctors, who generally follow this guide to judge the patient. There are two criterions that can diagnose diabetic nephropathy, the first is microalbuminuria, accompanied by fundus lesions. Microalbuminuria is relatively small amount of protein in urine, the total is not more than 0, 3 grams daily, or count it every minute, not more than 200 micrograms per minute and these can be called microalbuminuria. If the microalbuminuria patients have fundus lesions at the same time, the patients can be clinically diagnosed with diabetic nephropathy, which is criterion one. Second, the clinical daily urine protein is more than 0, 3 grams in diabetes patients, this case can basically be determined with diabetic nephropathy. Sometimes we look at the urine routine test result and say that there are a “+” or two “+” sign of urine protein. This is only qualitative and not very reliable. It must be done for 24 hours. More than 0, 3 grams of urine protein daily is called clinical dominant proteinuria, and diabetic patients with dominant proteinuria can generally be defined as diabetic nephropathy.

The two cases following do not belong to diabetic nephropathy. First, if there is proteinuria, whether it is a small amount, or a large number or clinical dominant, while hematuria appears, it is generally not diabetic nephropathy. There is a “+” sign in hematuria, and it's not accurate, either. If the first urine test strip has a plus sign, there may not be a “+” sign if it is checked again the second day. Patients with hematuria “+” sign can do urine sediment microscopy in order to determine whether they have hematuria. In addition, if the patient's kidney function is not good, but they still do not show proteinuria; such patients although having diabetic can not be diagnosed with diabetic nephropathy. However, when the doctor facing the patient, the patient's condition can not accord with this criterion, or with that criterion. The clinical situation is very complex, and it needs to combine various information to make a comprehensive judgment.

How to diagnose diabetic nephrosis

 

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