What are the clinical manifestations of diabetic nephropathy?2017-05-22 15:12
Diabetic nephropathy is a common complication of diabetes, diabetes is one of the systemic microvascular lesions, the clinical features were proteinuria, progressive renal dysfunction, hypertension, edema, late severe renal failure, is one of the main causes of death in patients with diabetes mellitus. In recent years, with China's per capita life extension, living habits, changes in the structure, the prevalence of diabetes in a linear upward trend, due to improvements in treatment, increase the survival time, and kidney and other complications also increased. According to the latest statistics, about 50 million people in China are now facing the threat of diabetes. In the United States, diabetic nephropathy is the leading cause of end-stage renal failure, accounting for about 35%-38%. Type I (IDDM) diabetes mellitus has a higher proportion of diabetic nephropathy, about 35%-50%, and the incidence of type II (NIDDM) is about 20%. However, in patients with diabetes mellitus, the incidence of type II patients is far more than type 1. Therefore, type II patients account for 70%-80% in patients with diabetes, renal failure and dialysis.
Diabetic nephropathy is a systemic disease caused by chronic hyperglycemia, which is caused by the absolute and relative deficiency of insulin and the metabolism of sugar, protein and fat. May all the diabetic renal involvement by different ways of structure damage of kidney damage, but there is a direct relationship between only glomerular sclerosis and diabetes, also known as diabetic nephropathy, diabetes is a systemic microvascular complication. Diabetic patients suffer from renal damage, persistent proteinuria, irreversible condition, often develop to end-stage renal failure. Diabetic nephropathy has become the leading cause of death in diabetic patients.
Diabetic nephropathy is more common in patients with diabetes over 10 years, proteinuria is the earliest manifestation of diabetic nephropathy, early symptoms, blood pressure can be normal or high. Urinary albumin excretion was measured by radioimmunoassay (200 micrograms per minute). This stage is called occult nephropathy or early nephropathy. If we can control hypertension and hyperglycemia, the disease will be improved. If the control is bad, with the progression of the disease can develop into clinical diabetic nephropathy, at this time can have the following clinical manifestations:
1. Proteinuria begins with increased glomerular filtration pressure and changes in the charge on the filter membrane. Only microalbuminuria occurs in the urine. It is selective proteinuria and no increase in globulin. This state of affairs is sustained for many years. With the increase of glomerular basement membrane filtration pores, large molecules can appear non selective clinical proteinuria, with the further development of the disease, urinary protein gradually become persistent if severe proteinuria, urinary protein more than 3 grams per day, is a sign of poor prognosis. The severity of proteinuria in diabetic nephropathy is progressive, until nephrotic syndrome occurs.
2, edema early diabetic nephropathy patients generally no edema, a small number of patients in plasma protein decreased before, there may be mild edema, when 24 hours urine protein more than 3 grams, edema will appear. Pronounced generalized edema is seen only in diabetic nephropathy.
3 hypertension and hypertension are common in patients with diabetic nephropathy. Severe nephropathy is associated with high blood pressure, while hypertension can accelerate the progression and deterioration of diabetic nephropathy. Therefore, effective control of hypertension is very important.
4, renal dysfunction, diabetic nephropathy once started, the process is progressive, nitrogen, uremia, is the final outcome.
5, anemia was azotemia in patients with diabetes, anemia can have mild to moderate, with iron therapy. Anemia is caused by a red cell disorder and may be related to a chronic protein restriction diet, which occurs in patients with hyperlipidemia.
6, other symptoms of retinopathy are not renal manifestations, but are often associated with diabetic nephropathy. Some people even believe that diabetic retinopathy is not possible without diabetic retinopathy.