How should diabetic nephropathy patients drink water?

Written by Zhou Qi
Nephrology
Updated on September 18, 2024
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For any kidney disease, regardless of whether it is caused by diabetes or not, the patient's water intake needs to be carefully considered. Generally, a few key points should be adhered to:

First, there should be no excess accumulation of water in the patient's body. The water intake should be excreted normally through the kidneys without accumulating too much water, as excessive accumulation can increase blood pressure and even lead to pulmonary edema or heart failure.

Second, if the patient's urine output decreases, water intake should be limited but not excessively, to avoid affecting the blood supply to the kidneys. Ideally, urine output should be maintained between 1000 to 2500 milliliters. Water intake should depend on urine output; if urine output is high, the patient can drink more water, but if it is low, intake should be appropriately restricted. It's necessary to weigh oneself daily to monitor changes in weight; if a large amount of water accumulates, weight will gradually increase, and at this time, water intake should be restricted.

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Written by Zhou Qi
Nephrology
2min 2sec home-news-image

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 Hu Lin
Nephrology
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What are the symptoms of diabetic nephropathy?

The symptoms of diabetic nephropathy mainly include the following aspects: The first one is proteinuria, where patients may notice an increase in foam in their urine, and upon examination, proteinuria will test positive. The second symptom is edema, which may initially appear as intermittent swelling but gradually develops into swelling of both lower extremities or even the entire body. Of course, pleural effusion and ascites may also occur. The third type of symptom is hypertension; diabetic nephropathy combined with hypertension often involves stubborn high blood pressure, which requires multiple antihypertensive drugs to control. The fourth point is that in the later stages of diabetes, signs of renal failure gradually appear, such as nausea, vomiting, difficulty breathing, anemia, renal osteopathy, skin itching, and more. The fifth is extrarenal manifestations, such as diabetic retinopathy presenting with vision loss or even blindness, and diabetic neuropathy leading to numbness and abnormal sensations in the hands and feet. Additionally, it is common for patients with diabetic nephropathy to also experience cardiovascular and cerebrovascular complications, such as coronary heart disease, myocardial infarction, stroke, and more.

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Written by Zhou Qi
Nephrology
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How should diabetic nephropathy patients drink water?

For any kidney disease, regardless of whether it is caused by diabetes or not, the patient's water intake needs to be carefully considered. Generally, a few key points should be adhered to: First, there should be no excess accumulation of water in the patient's body. The water intake should be excreted normally through the kidneys without accumulating too much water, as excessive accumulation can increase blood pressure and even lead to pulmonary edema or heart failure. Second, if the patient's urine output decreases, water intake should be limited but not excessively, to avoid affecting the blood supply to the kidneys. Ideally, urine output should be maintained between 1000 to 2500 milliliters. Water intake should depend on urine output; if urine output is high, the patient can drink more water, but if it is low, intake should be appropriately restricted. It's necessary to weigh oneself daily to monitor changes in weight; if a large amount of water accumulates, weight will gradually increase, and at this time, water intake should be restricted.

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Written by Luo Han Ying
Endocrinology
1min 7sec home-news-image

Is early diabetic nephropathy reversible?

Diabetic nephropathy clinically mainly manifests as an increase in urine protein on routine urine tests. Thus, diabetic nephropathy can be classified into different stages. In the early stages, microalbuminuria appears, and at this early phase, diabetic nephropathy is actually reversible. However, if the condition progresses with significant proteinuria, it becomes difficult to reverse diabetic nephropathy through intervention treatments. Most clinical patients may experience a slight reduction in urine protein or maintain this condition long-term without further progression. However, some patients have already experienced an increase in creatinine levels by the time they reach this stage of diabetic nephropathy, making it particularly challenging to reverse the condition once creatinine levels rise. Therefore, for diabetic nephropathy, early detection and treatment are crucial, with the most important goal being the prevention of the disease's onset.

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Written by Zhou Qi
Nephrology
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Does diabetic nephropathy require a biopsy?

Whether a patient with diabetic nephropathy needs a biopsy depends on the condition of the patient. Firstly, if the kidney disease is in the early stages and the blood creatinine level has not exceeded 256 micromoles per liter, a kidney biopsy can be considered. Otherwise, if the blood creatinine level exceeds 256 micromoles per liter, a biopsy is no longer meaningful since significant fibrosis and hardening of kidney tissue have already occurred. At this point, if it is unclear whether the proteinuria is caused by diabetes or another disease, a kidney biopsy can be considered to diagnose the cause and extent of glomerular damage, and to provide a basis for treatment.