Does diabetic nephropathy require a biopsy?

Written by Zhou Qi

Nephrology

Updated on September 05, 2024

00:00

00:00

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.

Other Voices

home-news-image

Written by Zhou Qi

Nephrology

1min 1sec

home-news-image

How to reduce proteinuria in diabetic nephropathy.

A major clinical feature of diabetic nephropathy is the occurrence of proteinuria, which, if the condition continues to progress, can lead to kidney failure. Controlling proteinuria in the early stages of the disease is indeed very important. In terms of treatment, it is primarily necessary to use medications or insulin to control the patient's blood sugar, as hyperglycemia is the fundamental cause of diabetic nephropathy. Additionally, these patients often also have hypertension, necessitating the use of antihypertensive drugs to control blood pressure. When the patient's kidney function is not severely impaired, ACE inhibitors or ARBs can be the preferred choice of antihypertensive drugs, as they not only control blood pressure but also reduce proteinuria. However, if the patient's serum creatinine is significantly elevated, such as over 264 µmol/L, these drugs should no longer be used. (Medications should be used under the guidance of a doctor.)

home-news-image

Written by Zhou Qi

Nephrology

1min 7sec

home-news-image

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.

home-news-image

Written by Zhou Qi

Nephrology

49sec

home-news-image

Can diabetic nephropathy be controlled?

The treatment of diabetic nephropathy is indeed a medical challenge currently. This disease is related to metabolic disorder, with factors such as high blood sugar state advanced glycation end products and oxidative stress contributing to the damage of the glomerular capillaries. Presently, there is no cure for this disease, nor is there a specific effective treatment. However, many patients have used certain treatments that can effectively delay the progression of the disease. Clinically, common measures include controlling blood sugar, blood pressure, and blood lipids. Additionally, combining the use of ACE inhibitors or angiotensin receptor blockers with sodium-glucose cotransporter 2 inhibitors can reduce the pressure within the renal corpuscles and lower urine protein levels.

home-news-image

Written by Zhou Qi

Nephrology

42sec

home-news-image

Early signs of diabetic nephropathy

Diabetic nephropathy is caused by long-term diabetes leading to damage in the small blood vessels. Generally, patients have a history of diabetes for over ten years. Diabetic nephropathy progresses through several stages. In the early stages, patients primarily exhibit microalbuminuria. Due to the presence of protein in the urine, patients may experience increased urine foam, especially noticeable with morning urination. Some patients may develop swelling in the lower limbs and around the eyelids. As the condition progresses, the amount of urine protein increases and the swelling becomes more pronounced, potentially reaching the level of nephrotic syndrome.

home-news-image

Written by Zhou Qi

Nephrology

54sec

home-news-image

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.