Diabetic Nephropathy is divided into five clinical stages:
Stage 1: starting stage of diabetic nephropathy. Glomerular filtration rate
is higher than normal. Kidneys are enlarged obviously due to long-term of high
filtration from Diabetes.
Stage 2: urine albumin excretion rate is within normal range in most cases,
or may increase intermittently after exercise. There exist thickening of
glomerular basilar membrane and mesangial proliferation from pathology.
Glomerular filtration rate is still higher than normal and is in consistent with
blood glucose reading.
Stage 3. Pre-clinical stage of diabetic nephropathy. Urine albumin excretion
rate at 20-200ug/min, which is evidence for impaired glomerular filtrating
structures and diagnosis of Diabetic Nephropathy. In many cases, blood pressure
begins to increase at stage 3.
Stage 4 Diabetic Nephropathy-clinical proteinuria stage.
After Diabetes 15-25 years, 40% Diabetics will develop into this stage. Urine
protein amount more than 0.5g/24h. GFR begins to decrease. Most patients develop
edema in eyelids, limbs, ankles, etc due to fluid retention in their body.
Stage 5- end stage renal failure
GFR<15; patients have overall symptoms such as anemia, itchy skin, poor
appetite, vomiting, headaches, weakness, etc. High creatinine and BUN levels.
High blood pressure. Electrolyte imbalances, such as high phosphorus,
hypernatronemia, low calcium, high phosphorus, etc. The patients may need to
dialysis and kidney transplant to sustain their life.