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The treatment of diabetic nephropathy need to understand the key issues

2017-07-26 10:27

How to do a good job of diabetic nephropathy, the combination of traditional Chinese medicine and Western medicine, clinical prevention and control professor Li Jianmin give you the following opinions:

The parameters of the early damage of periodic review of screening for kidney, active application of combining traditional Chinese and Western medicine clinical indicators such as means to control the content of diabetes control: glycated hemoglobin, blood glucose, blood glucose control reduces more than 30% fluctuations; actively using ACEI and ARB drugs to control blood pressure to protect kidney; active use of statins to promote blood lipids; regularly review whether uric acid control standard.

Positive annual diabetic patients with early renal damage index as screening for microalbuminuria, renal interstitial damage index for patients with active use of combining traditional Chinese and Western medicine clinical treatment, can clear to block the progression of clinical stage diabetic nephropathy proteinuria.

For clinical stage diabetic nephropathy proteinuria, 24 hour urinary protein quantitative analysis of more than 0.5 grams or more, calculated glomerular filtration rate than 60ml/min patients, combined with clinical analysis of the treatment by traditional Chinese medicine and Western medicine, with a clear reduction of urinary protein in clinical stage.

For clinical stage diabetic nephropathy proteinuria, 24 hour urinary protein quantitative analysis of more than 4 grams or more, calculated glomerular filtration rate less than 60ml/min patients, through the combination of traditional Chinese and Western medicine treatment of the clinical stage to reduce proteinuria, to stabilize renal function, reduce cardiovascular and cerebrovascular events as the principle.

For clinical stage diabetic nephropathy proteinuria, 24 hour urinary protein quantitative analysis of more than 0.5 grams or more, calculated glomerular filtration rate is less than 30ml/min, serum creatinine increased, patients with renal dysfunction, combined with clinical analysis of the treatment by traditional Chinese medicine and Western medicine, try to reduce the clinical proteinuria in stable renal function, reduce cardiovascular events as the principle at the same time, needs the positive analysis glomerular filtration rate, increase load capacity analysis and active control of blood pressure, improve heart function, analysis of anemia, uric acid and other indexes. For such patients regardless of whether serum creatinine to dialysis index, if it can not maintain the body water balance lead to excessive weight gain appeared hydrothorax ascites, severe edema and even pericardial effusion and cardiac function of recommendations for dialysis treatment; metabolic acidosis and severe hyperkalemia normal clinical treatment, repeated in the short term, it is difficult to maintain the normal value the scope of recommended hemodialysis treatment.

Diabetic nephropathy with combination of TCM and Western medicine clinical conservative treatment is very difficult, need to stick to it for a long time, if you have a sharp growth, the rapid deterioration of renal function and proteinuria, renal medicine to the hospital, even the need to clear the pathological changes of renal biopsy in diagnosis and treatment. Patients with diabetic nephropathy should, in particular, need to prevent hypoglycemia.

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