The formation of diabetic nephropathy is a process of diabetic nephropathy is
preventable and governance, according to the degree of the disease process of
diabetic nephropathy, the different stages of different treatment methods, the
prevention of diabetic nephropathy can not ignore, proactive and preventive to
avoid diabetesnephropathy, and then how to better treatment and prevention of
diabetic nephropathy?
Prevention and treatment of diabetic nephropathy principles: strict control of blood sugar, blood sugar close to normal levels as possible, to prevent and delay the occurrence of diabetic nephropathy; slow down the rate of decline of renal function; replacement therapy such as dialysis and renal transplantation. Specific therapeutic measures are as follows:
(1) strict control of blood glucose in the early stage of diabetes (diabetic nephropathy ID of before), strict glycemic control in patients with type 1 diabetes with insulin pumps or multiple subcutaneous insulin, blood glucose near normal levels, can delay or even prevent the occurrence of diabetic nephropathy and development to reduce the increased glomerular filtration rate and improve microalbuminuria.
The DCCT studies have shown that intensive insulin-consistent treatment in patients with type 1 diabetes, diabetic nephropathy, the risk decreased by 35% to 56%, once again proved that in the European diabetes meeting English mUKPDS study: type 2 diabetes with oral hypoglycemic agents or / and intensive insulin therapy, the occurrence of diabetic nephropathy and end-stage renal disease was significantly lower than the conventional treatment group, there is sufficient evidence that good control of diabetes prevention and treatment of kidney disease.
(2) control of hypertension, diabetes, hypertension will accelerate the development of diabetic nephropathy, antihypertensive, antihypertensive therapy can slow down the development of nephropathy and reduce urinary albumin excretion. British UKPDS study with hypertension, type 2 diabetes is a single p-blocker Atenolol is conducive to the prevention and treatment of kidney disease. Currently considered in the choice of antihypertensive drugs to angiotensin converting enzyme inhibitor efficacy, side effects, and a mild hypoglycemic effect, can be used as the first choice. Other antihypertensive drugs such as calcium antagonists, beta blockers, diuretics, alone or in combination with the condition of patients. Blood pressure in patients with diabetes should be controlled at below 140/90mmHg to 120/80mmHg or so as well. Observed that blood pressure dropped from 160/95mmHg to 135/85mmHg, urinary protein excretion was significantly reduced rate of decline of glomerular filtration rate from lml of / min / month dropped 0.35ml/min / month clinical diabetic nephropathy survival of also significantly longer, 10-year cumulative mortality of antihypertensive therapy for 50% to 70%, dropped to 18% after treatment.
(3) limit protein intake is appropriate to reduce the number of protein in the diet can reduce the pressure in the glomerular to reduce Gao filtration and reduce proteinuria.Associated with obvious edema (nephrotic syndrome) do not have to give too much protein, due to unfavorable condition, does not help the swelling subsided, it should give a low-salt diet and the strengthening of the diuretic, the preferred furosemide. Large doses of diuretics ineffective in the short term ultrafiltration treatment to remove large amounts of water savings in the body, to eliminate swelling.
(4) dialysis and kidney transplantation, renal failure, dialysis or kidney transplantation is the only effective way. Diabetic nephropathy caused by chronic renal failure, should be taken early dialysis, kidney transplant conditions should Beng line as soon as possible.
Certain set to do the work of the prevention of diabetic nephropathy. Must be in mid-note every day note, always pay attention. Because nephropathy contraindications enemy of the kidney disease treatment.
Prevention and treatment of diabetic nephropathy principles: strict control of blood sugar, blood sugar close to normal levels as possible, to prevent and delay the occurrence of diabetic nephropathy; slow down the rate of decline of renal function; replacement therapy such as dialysis and renal transplantation. Specific therapeutic measures are as follows:
(1) strict control of blood glucose in the early stage of diabetes (diabetic nephropathy ID of before), strict glycemic control in patients with type 1 diabetes with insulin pumps or multiple subcutaneous insulin, blood glucose near normal levels, can delay or even prevent the occurrence of diabetic nephropathy and development to reduce the increased glomerular filtration rate and improve microalbuminuria.
The DCCT studies have shown that intensive insulin-consistent treatment in patients with type 1 diabetes, diabetic nephropathy, the risk decreased by 35% to 56%, once again proved that in the European diabetes meeting English mUKPDS study: type 2 diabetes with oral hypoglycemic agents or / and intensive insulin therapy, the occurrence of diabetic nephropathy and end-stage renal disease was significantly lower than the conventional treatment group, there is sufficient evidence that good control of diabetes prevention and treatment of kidney disease.
(2) control of hypertension, diabetes, hypertension will accelerate the development of diabetic nephropathy, antihypertensive, antihypertensive therapy can slow down the development of nephropathy and reduce urinary albumin excretion. British UKPDS study with hypertension, type 2 diabetes is a single p-blocker Atenolol is conducive to the prevention and treatment of kidney disease. Currently considered in the choice of antihypertensive drugs to angiotensin converting enzyme inhibitor efficacy, side effects, and a mild hypoglycemic effect, can be used as the first choice. Other antihypertensive drugs such as calcium antagonists, beta blockers, diuretics, alone or in combination with the condition of patients. Blood pressure in patients with diabetes should be controlled at below 140/90mmHg to 120/80mmHg or so as well. Observed that blood pressure dropped from 160/95mmHg to 135/85mmHg, urinary protein excretion was significantly reduced rate of decline of glomerular filtration rate from lml of / min / month dropped 0.35ml/min / month clinical diabetic nephropathy survival of also significantly longer, 10-year cumulative mortality of antihypertensive therapy for 50% to 70%, dropped to 18% after treatment.
(3) limit protein intake is appropriate to reduce the number of protein in the diet can reduce the pressure in the glomerular to reduce Gao filtration and reduce proteinuria.Associated with obvious edema (nephrotic syndrome) do not have to give too much protein, due to unfavorable condition, does not help the swelling subsided, it should give a low-salt diet and the strengthening of the diuretic, the preferred furosemide. Large doses of diuretics ineffective in the short term ultrafiltration treatment to remove large amounts of water savings in the body, to eliminate swelling.
(4) dialysis and kidney transplantation, renal failure, dialysis or kidney transplantation is the only effective way. Diabetic nephropathy caused by chronic renal failure, should be taken early dialysis, kidney transplant conditions should Beng line as soon as possible.
Certain set to do the work of the prevention of diabetic nephropathy. Must be in mid-note every day note, always pay attention. Because nephropathy contraindications enemy of the kidney disease treatment.
