Diabetic kidney disease can be divided into 5 stages according to the amount of albumin in urine and severity of renal damages.
5 stages of diabetic kidney disease
1. Glomeruli and kidneys are enlarged. Patients can have foams in urine which can be recovered after insulin treatment.
2. It occurs 2 years after the onset of diabetes and some patients can stay in this stage for years without progressing into the 3th stage. If blood sugar is not well controlled or after strenuous activities, patients can have microalbuminuria which is still reversible.
3. It is high-risk and also very crucial period for diabetic kidney disease patients. Typical diabetic kidney disease develops into this stage after 10-15 years with continuously worsening bubbles in urine. Patients will begin to have high blood pressure. Well control of high blood pressure can alleviate proteinuria, slow down illness progression and protect kidney functions.
4. It is called clinical diabetic kidney disease characterized by massive albumin in urine, swelling, high blood pressure. It takes about 15-25 years to progress into this stage and daily protein leakage in urine increases to more than 0.5g. Effective anti-hypertensive treatment can slow down decline rate of GFR and protect kidney function.
5. It is the end stage of diabetic kidney disease with severe hypertension and serious uremic states and advanced renal damages.
Treatments for diabetic kidney disease
Diabetic kidney disease can also be divided into early and clinical diabetic nephropathy in clinic. Early stage is microalbuminuria and clinical stage is obvious albumin in urine. Monitoring and treating protein in urine is very crucial for diabetic kidney disease patients. Once there is clinical proteinuria, renal functions will experience irreversible and continuous decline and the average life expectancy after proteinuria is about 10 years.
Well control of high blood pressure is also effective at reducing proteinuria and protecting kidney functions.
ACEI and ARB drugs are commonly prescribed to treat proteinuria, lower high blood pressure. However when illness has progressed into the end stage, dialysis, kidney transplant, Micro-Chinese Medicine Osmotherapy and immunotherapy will be offered.
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