Stages of Diabetic Nephropathy and Their Symptoms

In the western countries, Diabetic Nephropathy is the primary cause of End Stage Renal Failure. It is very common among diabetics with a long disease history. According to the different symptoms of Diabetic Nephropathy, the patients should receive specific treatments based on their own disease conditions. Therefore, it is very important for patients to know the stages of Diabetic Nephropathy and the symptoms in different stages.
First, the following form lists the five stages of Diabetic Nephropathy

Stages of Diabetic Nephropathy	Glomerular Filtration Rate (GFR)	urinary albumin excretion rate	proteinuria	blood pressure
Stage 1: glomerular hyperfiltration	Increase	Normal	Negative	Normal
Stage 2: normal albumin	Increase or keep normal	Normalor increase in stress states	Negative	Normal or increase slightly
Stage 3: early Diabetic Nephropathy	Roughly normal	Increase	Negative	Increase
Stage 4: Clinical Diabetic Nephropathy	Decline gradually	Increase obviously	Positive	Increase obviously
Stage 5: Renal Failure	Decline seriously	Increase obviously	Mass of proteinuria	Increase obviously

Second, the clinical symptoms of Diabetic Nephropathy
1. Proteinuria
If the patients with Diabetic Nephropathy, it proves that their disease has developed into stage 4, namely clinical Diabetic Nephropathy. In the stage 2 and 3 of Diabetic Nephropathy, the patients occasionally have intermittent or persistent microalbumin, but their urine routine examination result shows negative. After their diseases develop into clinical Diabetic Nephropathy, the proteinuria will increase gradually. Usually, the patients will have mass of proteinuria in 3~5 years and even develop Nephrotic Syndrome.
2. Edema
With the proteinuria appearing, their patients will have edema. When the mass of proteinuria cause hypoproteinemia, it can cause blood plasma colloid osmotic pressure to decline. Therefore, the patients will have serious edema and even have ascitic fluid and hydrothorax.
3. Hypertension
Hypertension is an early symptom of Diabetic Nephropathy and can appear in stage 2 or 3. In the early stage, the patients usually have intermittent high blood pressure and gradually develop into persistent blood pressure. In return, Hypertension can aggravate the execration of proteinuria thus accelerating the renal damage, which is an important factor in aggravating renal damage.
4. Renal damage
Before Diabetic Nephropathy develops into Clinical Diabetic Nephropathy, the renal damage develops very slowly. However, with the appearance of persistent proteinuria, especially mass of proteinuria, their renal function declines very rapidly.
Generally speaking, if the patients can receive treatments in stage 1, their renal function can recover normal. In stage 2 and 3, their renal function can be improved to some extent with effective treatment. However, once their disease develops into stage 4, their renal function will decline at a fast speed. At that time, the patients can only treat the symptoms of the disease.
Therefore, the patients with Diabetes should do renal function examination, urine test and blood test regularly. If they have the above symptoms, they should receive treatment at once so as to preserve their renal function effectively.