Symptoms of Diabetic Nephropathy in Five Installments

According to experts, the introduction of changes in the clinical manifestations of diabetic nephropathy is very large, when the initial basic symptoms difficult to be found, depending on the extent of its clinical manifestations in patients with diabetic nephropathy in which the stage and renal dysfunction, in fact, diabetes is not the only simple both early and late stages, then what stage of the disease in the end it?

Ⅰ period: to glomerular filtration and renal characterized by mild increases. GFR showed elevated glomerular capillary plasma flow increases and increased pressure within the capillaries and other hemodynamic changes. GFR increased from 25% to 40%, up to 150ml / min, kidney volume increase of about 25%, but no significant change in histopathological nor any clinical symptoms. The general method for clinical diagnosis can not be found, as the initial diabetes.
Phase

Ⅱ: Closed no urine protein displacement increased. After the exercise challenge, there may be increased urinary protein displacement. The beginning of the glomerular structural damage, but the Department of reversibility. During this period may be higher GFR, can be more than 150ml / min, some patients blood pressure began to rise from the original foundation. During this period, such as early intervention therapy can glomerular structure and function return to normal.

Ⅲ: performance of persistent urinary albumin displacement (UAE) increased (20 ~ 200μg / min), is highly selective proteinuria, called early kidney disease, also commonly referred to that early DN. In the period roughly GFR gradually returned to normal levels, blood pressure can be slightly increased, but less than high blood pressure levels. Early DN in GFR have a certain relationship with glycemic control and increased state plasma flow, both glycemic control may decrease after. It was found that giving high-protein diet, GFR can be increased, but the limit protein diets, GFR can be reduced.

Period Ⅳ: namely clinical nephropathy. Before early diagnosis of urinary albumin and other applications, the clinical diagnosis of multiple DN For this period. This period is characterized by a progressive increase in clinical emergence non-selective proteinuria, GFR gradually decline. Histopathological changes in the progressive development of glomerulosclerosis.

Ⅴ period: uremia. Further development of diabetes clinical proteinuria, the renal function gradually diminishes, until you reach the end stage that uremia. At this point, often significantly increased renal glucose threshold and increased urine obvious clinical manifestations of kidney damage varied changes, involving multiple systems, severe lesions can be different for each system. Uremia and other end-stage kidney disease due to similar clinical manifestations of DN.


Doctor Network Tips: These are the five stages of diabetic nephropathy. Patients with persistent or recurrent significant proteinuria, clinical manifestations changed much. This period may be outside except some selective early proteinuria, mainly non-selective proteinuria. From diabetes to diabetes onset proteinuria, urinary protein increased by more than 5 to 20 times.