If diabetes is not well controlled, it is easy to get complications, and if you have kidney disease, you will also have eye disease, etc., so you must prevent kidney disease
Why do diabetics get kidney disease?
When people with diabetes have poor glycemic control, a hyperglycemic state can damage microvessels throughout the body, including the kidneys.
First of all, high blood sugar can cause damage to the endothelial cells of blood vessels, making it easier for harmful substances in the blood such as creatinine and urea to penetrate into the kidneys. These harmful substances can further damage kidney tissue, leading to a decline in kidney function.
Second, a long-term hyperglycemic state can lead to kidney fibrosis, which alters the structure and function of the kidneys. These fibrotic processes lead to kidney atrophy and decreased kidney function, which can eventually lead to uremia.
In addition, diabetes can affect the function of the renal tubules. The tubules are an important part of the kidneys and are responsible for reabsorbing water and electrolytes from the urine. When the renal tubules are damaged in diabetic patients, the reabsorption function is affected, resulting in an increase in water and electrolytes in the urine, which in turn increases the burden on the kidneys.
Finally, diabetes can also cause damage to the sympathetic nerves in the kidneys. The sympathetic nerve, the main nerve that controls blood flow to the kidneys, can be damaged when kidney blood flow is compromised, further impairing kidney function.
Stages of diabetic nephropathy
Diabetic kidney damage is a slow and continuous process, like freezing three feet and not a day's cold. Clinically, diabetic nephropathy is divided into five stages, each with its own unique manifestations and progression. It usually takes 20 to 30 years from the onset of diabetes to end-stage renal disease. However, if diabetes is poorly controlled or inadequate, the time of uremia may be advanced by 10 years. This is like a traveler walking on a long road, if you are not careful, you may step into the end early. Therefore, for people with diabetes, a consistent, stable** and healthy lifestyle is the key to preventing kidney damage.
Kidney damage due to diabetes can be divided into five stages
Phase 1. Glomerular hyperfiltration expired
In this phase, glomerular filtration rate or creatinine clearance is elevated, and the kidney volume increases, but the urinary microalbumin excretion rate is normal and blood pressure is normal, which can be reversed if hyperglycemia is corrected in time.
Phase 2
Intermittent microalbuminuria
This stage is the earliest stage of diabetic nephropathy. At this stage, glomerular filtration rate or creatinine clearance may increase slightly or fall into the normal range, while urinary microalbumin excretion is normal at rest and increases after exercise. Blood pressure remains normal at this stage. However, stage 1 and stage 2 are usually not easily detected early, so it is advisable for diabetic patients to be hospitalized annually for a detailed and comprehensive examination to detect these conditions as early as possible. At this stage, diabetic nephropathy is most effective, and early can lead to a complete reversal of the condition.
Phase 3
Early diabetic nephropathy stage
This stage is the early stage of nephropathy, with a roughly normal glomerular filtration rate but persistent elevated urine microalbumin (> 20 to 200 mcg minutes or 30 to 3000 mg for 24 hours).
Urine routine tests are negative for protein in the urine, and blood pressure is normal or has an upward trend. It is generally believed that the kidney lesion is irreversible from this stage onwards.
Issue 4. Clinical diabetic nephropathy stage
At this stage, there is overt albuminuria, decreased glomerular filtration rate, persistent proteinuria (> 200 micrograms per minute or 300 mg for 24 hours), ordinary urine routine examination can be positive, and even manifestations of nephrotic syndrome such as massive proteinuria, edema, and hypertension appear.
5 installments. The stage of renal failure is the stage of end-renal disease, also known as uremia
As glomerular filtration rate or creatinine clearance decreases further, the amount of proteinuria excreted may gradually decrease, and patients may develop symptoms such as anemia, fatigue, nausea, and resistant hypertension. Early detection is crucial for people with diabetes. Usually, if the diabetic lesion persists for about 10 years, the diagnosis of early diabetic nephropathy is made by persistent positive urine microalbumin. The impact of this condition on patients is significant, so early detection and ** are essential to improve the quality of life and prognosis of patients.
The natural history of diabetic nephropathy is as follows
Early renal hypertrophy, hyperfunction Normal albuminuria Microalbuminuria (early diabetic nephropathy) Proteinuria (clinical diabetic nephropathy) Chronic renal failure (uremia).
How can I slow the progression of diabetic nephropathy?
Lifestyle changes
Proper blood sugar control
Effective blood sugar control for a long time is like building a solid line of defense for the health of the kidneys, which can help sugar friends delay the progress of diabetic nephropathy. As kidney disease progresses, the use of oral hypoglycemic drugs becomes more and more limited, and the regulation of hyperglycemia becomes an increasingly difficult challenge, and the risk of hypoglycemia is also quietly increasing. And hypoglycemia, a seemingly sweet trap, is actually a damage to the kidneys that cannot be ignored.
Therefore, it is undoubtedly crucial for sugar friends with diabetic nephropathy to maintain blood sugar stability and achieve moderate blood sugar control. When renal function is severely impaired, insulin** should be preferred. Sugar lovers should monitor their blood sugar closely and try to avoid high and low fluctuations in blood sugar. It's not just about controlling blood sugar, it's about protecting our kidneys so they can walk with us on the road to health.
Control your blood pressure
A frequent visitor to diabetes, high blood pressure, like a latent beast, is always ready to accelerate the onset and progression of diabetic nephropathy. Controlling blood pressure, like putting a wild animal in a cage, can effectively delay the progression of diabetic nephropathy. Therefore, blood pressure reduction** is equally important.
Non-pregnant** blood pressure is recommended to be controlled below 140 80mmHg, this is to protect our kidneys and allow them to work in a healthy environment. In the case of effective blood pressure**, the preferred drugs are angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor antagonists (ARBs). These two classes of drugs act like guardians of the kidneys, not only effectively lowering blood pressure, but also having additional kidney-protective effects.
For older people and people with severe kidney disease, blood pressure goals need to be set on an individual basis and condition. It's like everyone is unique and needs to be tailored to their situation. Please follow your doctor's advice for details.
Lipid target
Hyperlipidemia is also one of the factors that contribute to the development and worsening of diabetic nephropathy and should be actively corrected.
Control proteinuria
The interaction between diabetic nephropathy and urine protein is like the moon and stars in the night sky, complementing and influencing each other. When diabetic patients enter the early stage of kidney disease, which is the microalbuminuria phase, the presence of protein in the urine is like an early warning sign that we need to take steps to reduce the production of protein in the urine.
At this point, your doctor will recommend ACE inhibitors or angiotensin receptor antagonists, which act like a fleet of escorts to help us guard the health of our kidneys. These drugs can effectively reduce the production of protein in the urine, thereby reducing the burden on the kidneys and delaying the progression of diabetic nephropathy.
Of course, diabetic nephropathy is not achieved overnight, and sugar friends need to actively manage blood sugar, blood lipids and blood pressure and other indicators under the guidance of professional medical personnel. At the same time, it is also important to avoid drugs with kidney damage to avoid making matters worse.
Sugar friends also need to regularly monitor indicators such as kidney function to keep abreast of the progress of kidney disease. Once an abnormality is found, the medical staff will adjust the plan according to the condition to ensure that the effect is maximized.
Through these efforts, we can effectively delay the progression of diabetic nephropathy and avoid the occurrence of kidney failure as much as possible. The health of the kidneys needs to be guarded by each and every one of us. Let's take action together and take responsibility for our own health!