Treatment of Anemia in Diabetic Nephropathy

Written by Zhou Qi

Nephrology

Updated on September 21, 2024

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Compared to primary chronic nephritis, patients with diabetic nephropathy develop anemia earlier and more severely. The treatment for this type of anemia is divided into two aspects. Firstly, since it is anemia caused by renal lesions leading to a lack of erythropoietin, it is necessary to supplement erythropoietin, as well as iron and folic acid, which are raw materials for blood production, for the anemia caused by diabetic nephropathy. Additionally, patients with diabetic nephropathy are prone to malnutrition and should enhance nutritional support, especially by increasing the intake of high-quality animal protein.

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Written by Zhou Qi

Nephrology

55sec

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How many years can a person with diabetic nephropathy live?

Diabetic nephropathy is divided into several stages, from mild to severe. In the early stage, patients only have an increased glomerular filtration rate and the proteinuria is not significant. As the disease progresses, the protein in the urine increases, eventually leading to renal failure and even developing into uremia. The entire process can last many years, with some patients experiencing it for up to ten years. In fact, when diabetic nephropathy progresses to its final stage, uremia, patients still have many treatment options, such as hemodialysis, peritoneal dialysis, or kidney transplantation, and even combined kidney and pancreas transplantation. Therefore, how long a patient can live depends on the patient's age, presence of cardiovascular and cerebrovascular diseases, and the choice of treatment methods, among other factors.

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Written by Zhou Qi

Nephrology

54sec

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Is diabetic nephropathy dialysis painful?

Whether it is diabetes, nephritis, high blood pressure, or other causes leading to kidney failure, it may eventually progress to uremia. Patients with such conditions need dialysis or a kidney transplant to survive. Generally, patients undergoing any type of dialysis do not experience significant pain symptoms. Dialysis can be divided into hemodialysis and peritoneal dialysis, both of which use artificial methods to remove metabolic waste from the patient's body and maintain the stability of the internal environment. These methods generally do not involve significant traumatic procedures, so they mostly do not cause notable pain. However, patients undergoing hemodialysis may need temporary needling each time, which causes minimal trauma and typically does not result in severe pain or significant discomfort.

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Written by Zhou Qi

Nephrology

2min 2sec

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Is diabetic nephropathy stage 3 reversible?

Patients with diabetic nephropathy actually have an irreversible condition. If a patient has developed mild to moderate proteinuria and entered stage three, it's generally because of long-term high blood sugar, oxidative stress, and an excess of glycation end products damaging the capillaries of the glomerulus, resulting in increased permeability and the occurrence of proteinuria. The damage that has already occurred cannot be reversed; however, patients still need active treatment to control their blood sugar and blood pressure in order to slow down the progression of diabetic nephropathy as much as possible. Stage three diabetic nephropathy is incurable, but treatment can slow the progression of the kidney disease, preventing the development from microalbuminuria to macroalbuminuria. Stage three refers to the early period of diabetic nephropathy, typically seen in diabetic patients who have had the disease for more than five years. It can feature a continuous increase in urinary albumin excretion rates. High filtration rates and long-term poor metabolic control may be reasons for the persistent microalbuminuria. During this stage, patients may experience a mild increase in blood pressure, and reducing blood pressure can decrease the excretion of microalbumin. During this period, strict control of blood sugar is necessary. Oral hypoglycemic drugs can be used for treatment, and it's crucial to regularly monitor fasting blood glucose, postprandial blood glucose, and glycated hemoglobin. Blood pressure should also be actively controlled, generally targeting a value of 130/80mmHg. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists are preferred as they can lower blood pressure, reduce proteinuria, and have a protective effect on the kidneys, thus delaying the progression of kidney disease.

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Written by Zhou Qi

Nephrology

51sec

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How is diabetic nephropathy treated?

The treatment of diabetic nephropathy also depends on the specific stage the patient is in. During stages one to three, the main clinical treatments include controlling blood sugar, blood pressure, and lipids. Patients with diabetes often also have these metabolic disorders, including hypertension and hyperlipidemia, which can damage the kidneys. In addition, in the early stages, some medications are often chosen to reduce the pressure on the glomeruli. For example, using ACE inhibitors or angiotensin receptor blockers (ARBs) and inhibitors of the sodium-glucose cotransporter, these drugs can also slow the progression of kidney failure. However, if the patient's condition has progressed to stage five, which is essentially equivalent to the state of uremia, the patient will then need dialysis treatment.

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Written by Zhou Qi

Nephrology

1min 7sec

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Early symptoms of diabetic nephropathy

Diabetic nephropathy is divided into five stages. In the first and second stages, patients generally do not have significant proteinuria. At this time, the pressure inside the glomeruli increases, and the glomerular filtration rate actually increases, which may result in an increase in kidney size. During this period, patients generally do not have obvious symptoms, and it is difficult to detect without detailed examination. By the third stage, patients develop proteinuria, which increases as the disease progresses, and patients may notice an increase in urine foam. When diabetic nephropathy reaches the stage with proteinuria, a prominent clinical symptom is edema. This edema initially appears in the bilateral facial and lower limb areas. As the disease progresses, some patients may also experience generalized edema, and can develop effusion in the pericardium, thoracic cavity, and abdominal cavity. Symptoms such as chest tightness, shortness of breath, difficulty breathing, pulmonary edema, and heart failure may occur.