Clinically, the diagnosis of early Diabetic Nephropathy mainly depends on the
detection of microdose albumin in urine. In the early period of Diabetic
Nephropathy, it is mainly characterized with urine protein. Therefore, the
detection of urine protein is very important for the diagnosis of Diabetic
Nephropathy.
In the urine of healthy person, the microdose alnumin is less than 10
microgram/min. In half of year, if three times of inspections of microdose
albumin in urine is between 20 micrograms and 200 micrograms, and also can
exclude some possible causes in leading the microdose albumin in urine to
increase like Diabetic ketoacidosis, hypertension, exercise, heart failure and
so on. The patients can be diagnosed with early Diabetic Nephropathy. This part
of patients does no have clinical urine protein because it can be inspected out.
If the albumin excretion rate is above 200 micrograms/min and the urine protein
excretion exceeds 0.5 grams, it is called clinical proteinuria.
Once clinical protein in urine appears, it proves that the kidneys have had
serious pathological changes. Compared with the patients without clinical
protein in urine, its prognosis is worse. It usually takes three to five years
from the occurrence of protein in urine to obvious decline in renal function,
but it may vary with different cases. The protein in urine for the patients with
Diabetic Nephropathy usually progressively develops.
Once the patients with Diabetes have clinical protein in urine, it is very
important to take relative treatments to protect the residual renal function and
delay the aggravation of renal function.
1. Control blood glucose: The patients with Diabetes should keep their empty
glucose level within 7.8 mmol/L and 2 hour-postprandial blood glucose level
below 10 mmol/L.
2. Prevent and treat high blood pressure: ACE not only has an effective
function in lowering blood pressure, but also can decline the excretion of
protein in urine. They should keep their blood pressure within 120~130/70~80
mmHg.
3. Keep a low vegetable protein and low phosphorus diet. Low-protein diet can
slow down the glomerular filtration rate delaying kidney disease progression.
They should keep the protein intake within 0.6~0.8 grams per body weight in
kilogram and improve the animal protein proportion in the total protein intake.
Low-phosphorus diet can decrease urine nitrogen, urine protein, blood pressure
and creatinine level thus preventing kidney disease progression.
If the patients with Diabetes can decline the excretion of protein in urine,
it will slow down the renal injury progression and even stop it from developing
into Diabetic Nephropathy. If you want to know more about other aspects about
how to prevent Diabetes from developing into Diabetes like the treatment of
Diabetes, the diet of Diabetes and so on, you can email to kidney-treatment@hotmail.com.