China Diabetes Association survey found that the incidence of diabetes in China reached 9.7%, it is estimated that nearly 100 million people
China Diabetes Association survey found that the incidence of diabetes in China reached 9.7%, it is estimated that nearly 100 million people with diabetes in China, has surpassed India to become the world's largest diabetes. Diabetic nephropathy is one of the most dangerous complications of diabetes mellitus. In Europe and the United States, diabetes has become the main cause of chronic kidney disease and end-stage renal disease, accounting for more than 50% of patients with end-stage renal disease. In China, the kidney disease caused by diabetes has become the main cause of end-stage renal disease, second only to primary glomerulonephritis and hypertension. Therefore, the control of blood sugar, prevention and treatment of diabetic kidney damage has reached an urgent moment.
Normal kidneys filter out large amounts of metabolic waste from the blood every day to maintain balance in the body. Diabetic patients with poor blood glucose control, resulting in high blood glucose concentration, the kidneys were forced to overload, to filter the blood glucose. In the end, the kidneys that continued to work at high loads did not do well in the filtration of glucose, or even stopped working. In this way, diabetic kidney damage is difficult to avoid.
Diabetes - how does it affect the kidneys?
The kidney includes millions of capillary loops composed of nephron, acts as a blood filter. The blood flow through the capillary loops of metabolic wastes through the blood vessel wall and eventually excreted into the urine. When diabetic patients with poor glycemic control, high blood glucose levels lead to kidney overload to increase the filtration of glucose. This increased the permeability of capillary loops, and began to leak, not through the normal capillary wall protein leakage into the urine, proteinuria. If not before the appearance of proteinuria good blood glucose control, diabetic nephropathy progresses, the kidney can not remove toxic metabolites in the blood metabolism, serum creatinine, blood urea nitrogen increased gradually, eventually leading to renal failure. However, diabetes does not necessarily mean that diabetic kidney damage or renal failure. As long as the long-term good control of blood glucose, the risk of diabetic kidney complications is significantly reduced, many patients do not appear to be diabetic kidney damage.
Diabetes: renal damage caused by elevated blood pressure
Diabetic patients with elevated blood sugar caused by vascular disease, prone to elevated blood pressure or hypertension. High blood pressure is also one of the serious complications of diabetes, which can lead to cardiovascular dysfunction and systemic vascular damage. If the kidney is involved, it will not be able to remove the body's metabolic waste and excess fluid. Excess fluid retention in the blood vessels, leading to further increase in blood pressure, thereby further aggravating kidney damage, forming a vicious cycle. According to reports, the United States each year, 25000 patients with diabetes due to elevated blood pressure into the end stage renal failure. If diabetes and hypertension are present, there is a significant risk of kidney damage. At the same time, it is of great importance to prevent blood loss by reducing blood pressure, reducing salt intake and regular physical exercise.
Diabetes - prevention of renal damage
Once diagnosed with diabetes, you should be alert to the risk of diabetic kidney damage. Therefore, patients with diabetes should regularly go to the Department of Endocrinology and nephrology department to follow up blood glucose changes and check urinary albumin excretion rate, at least 2-3 times a year. Once the urine micro albumin increased, indicating that kidney damage, began to have protein leakage. If accompanied by elevated serum creatinine levels, the presence of metabolites in the kidneys. To effectively prevent the occurrence of diabetic kidney damage, it is necessary to effectively control blood glucose levels. Measures to control blood sugar include a specific diet plan, proper physical exercise, the use of insulin and other drugs, and regular blood glucose monitoring.
In addition, renal and urinary tract infection is also an important factor in renal damage in diabetic patients. Therefore, urinary tract irritation, lumbago, turbid urine, hematuria, fever, chills and other symptoms, should be timely medical treatment.
Diabetes: treatment of renal damage
Patients with diabetes if there is a sign of kidney damage, it should be based on diet and blood glucose control on the basis of drugs to reduce the burden on the kidneys, delaying the progress of kidney disease. I is currently recognized as a drug that delays kidney damage, including angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists (ARB). These 2 kinds of drugs can not only effectively reduce proteinuria and delay the progress of renal damage, but also significantly control hypertension. In addition, the renal damage such as Astragalus, Huangkui and progress of Chinese medicine has obvious therapeutic effect.
When renal damage in diabetes mellitus, some drugs with obvious renal toxicity should be avoided as far as possible. Such as a variety of antipyretic analgesics, anti infective drugs and contrast agents, in the case of diabetes, often leading to the progression of renal damage and should be avoided or try to use small doses.
In the end stage of diabetic renal injury, renal replacement therapy, such as peritoneal dialysis, hemodialysis or kidney transplantation, can only be based on the patient's general condition and economic conditions.