Additional Diabetes Information:
Apart from genetic factors, the crucial factor that determines whether Diabetic Nephropathy occurs is the long-term blood glucose control. The progression of Diabetic Nephropathy is gradual and accumulative, and there are five clinical stages of Diabetic Nephropathy. In general, type 1 Diabetics progress by one stage every 5 years, and type 2 Diabetics progress by one stage every 3 or 4 years if the blood glucose is not controlled well.
The first three stages of Diabetic Nephropathy belong to early pathological changes, with patients having no symptoms. Stage one can go back to normal and the progression of stage two and three can also be contained if treated effectively. The characteristic of stage one is increasing glomerulus filter rates (GFR), which can be reversed if blood glucose is controlled well. The characteristic of stage two and three patients is Microalbumin which only appears for stage two Diabetic Nephropathy patients when they exercise or have fever. If Microalbumin persists, the patients have stepped into stage three of Diabetic Nephropathy. In the treatment of stage two and three Diabetic Nephropathy, ACEI and ARBS are needed in addition to blood glucose control.
When the urine protein is positive during urine routine test, the Diabetic Nephropathy has developed into stage four known as “Clinical Diabetic Nephropathy period “. During this period, urine protein will evolve into large proteinuria (urine protein >3.5grams/day), which causes decreasing plasma protein, edema and hyperlipemia, which are all symptoms of nephrotic syndrome. Patients often have hypertension and kidney functions deteriorate quickly. If the condition aggravates further, Diabetic Nephropathy will develop into stage five, and the patients will have symptoms like inappetence, nausea and vomit, and increasing creatinine and urea nitrogen,who are highly likely to use dialysis to sustain their lives. Different from nephritis, kidney failure led by Diabetic Nephropathy is harder to treat, because they tend to have proteinuria and nephrotic syndrome. And Diabetic Nephropathy patients need dialysis treatment earlier.
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