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Clinical manifestations and staging

2017-02-02 16:43

 

Diabetic nephropathy is a kidney of diabetic complications, including early changes of Glomerular function: high perfusion, renal microvascular disease caused by progressive development of renal Glomerular fibrosis, renal failure each time different. According to proteinuria and Glomerular filtration rate (normal GFR is 80-120ml/min. ) And pathological changes of kidney clinic will be pided into 5 stages of diabetic nephropathy:

Stage I:

High performance high glucose-induced Glomerular perfusion and high filtration and renal hypertrophy, glomerular filtration rate, about 150ml/min. No significant tissue damage of kidney biopsy.

Phase II:

Normal albumin in urine. Urinary albumin excretion rate of <20ug/min or <30mg/24h; elevated or normal glomerular filtration rate, approximately 130-150ml/min; Glomerular basement membrane thickening and increased extracellular matrix.

Phase III:

Early stage of diabetic nephropathy, period of Microalbuminuria. Urinary albumin excretion ratio ≥ or ≥ 30mg/24h 20ug/min; normal glomerular filtration rate of about 130ml/min; Glomerular basement membrane thickening and increased extracellular matrix, some balls of tuberous sclerosis.

Phase IV:

Clinical diabetic nephropathy, a large number of albumin in the urine. Urinary albumin excretion ratio ≥ or ≥ 0.5G/24h 200ug/min; decreased glomerular filtration rate of about 60-130ml/min; Nodular Glomerulosclerosis, capillary lumen occlusion, hyaline degeneration of Glomerular sclerosis, glomeruli of some derelict.

V stage:

Uremia period. Decreased glomerular filtration rate, advanced <10ml/min; macroalbuminuria, Glomerular extensive hardening, abandoned.

This staging of ⅰ-ⅲ early changes, is the key to treatment of diabetic nephropathy, treatment can delay the development of diabetic nephropathy. IV-v are advanced lesions, particularly in drug therapy v, have been unable to save the kidney damage.

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