How is diabetic nephropathy diagnosed?

Written by Zhou Qi
Nephrology
Updated on September 01, 2024
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The diagnosis of diabetic nephropathy primarily relies on the clinical symptoms and medical history of the patient. Such patients often exhibit proteinuria, sometimes even severe proteinuria, and may also experience renal failure. Additionally, these patients have a history of diabetes, usually extending over ten years, followed by renal damage, and often accompanied by diabetic retinopathy. In such cases, a preliminary diagnosis can be made based on clinical features. However, there is still a risk of misdiagnosis, as the proteinuria could also be caused by other diseases affecting the glomeruli. Therefore, to confirm the diagnosis, it is best to conduct a renal biopsy, which can provide a definitive diagnosis.

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Written by Zhou Qi
Nephrology
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Symptoms of stage four diabetic nephropathy

Stage four of diabetic nephropathy indicates the presence of significant amounts of urinary protein. At this stage, patients may exhibit symptoms of nephrotic syndrome, which means the total urinary protein quantification over 24 hours may exceed 3.5 grams, and the plasma albumin level may be lower than 30 grams per liter. Due to the large amount of protein leakage, patients may experience edema, presenting as swelling of the lower limbs or eyelids, or even severe generalized swelling. In addition to edema, patients may also have pleural and abdominal effusion, leading to pulmonary edema. Excessive fluid can overburden the heart, causing heart failure, which manifests as chest tightness, shortness of breath, and difficulty breathing, especially when the patient is active, these symptoms of chest tightness and shortness of breath become more pronounced.

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Written by Pan Wu Shan
Nephrology
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What can diabetic nephropathy eat?

Diabetic nephropathy, as the name suggests, is a complication of the kidneys caused by long-term poor control of blood sugar in diabetes. Its most typical symptoms include significant proteinuria and potential body edema. Generally, there is no particularly good method to treat diabetic nephropathy; firstly, it is necessary to control blood sugar well, ensuring that fasting blood glucose does not exceed 7 mmol/L, and blood glucose two hours after a meal does not exceed 10 mmol/L. Additionally, some kidney-protective measures can be used to reduce urinary protein, etc. Furthermore, foods high in sugar, fried foods, and those high in starch should be avoided, such as potatoes, taro, sweet potatoes, and vermicelli, all of which should be consumed less.

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Written by Zhou Qi
Nephrology
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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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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.

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Which department should diabetic nephropathy patients see?

Diabetic nephropathy is damage to small blood vessels caused by diabetes, and the kidneys contain a large number of small blood vessels. Therefore, it generally takes more than ten years for diabetes to damage these small blood vessels, causing kidney lesions, proteinuria, renal failure, and other clinical manifestations. This disease can be treated in departments specializing in diabetes or endocrinology, as well as in nephrology. In the early stages of diabetic nephropathy, treatment primarily involves controlling blood sugar levels, and visiting departments like diabetes or endocrinology might be more specialized in this regard. These departments are proficient in adjusting medications for blood sugar control. When patients develop significant proteinuria, the condition progresses, and it is advisable to visit nephrology. At this point, the treatment focuses on the kidney lesions, as well as managing complications caused by diabetic nephropathy.