/Diabetic nephropathy stage 4

Diabetic nephropathy stage 4

author:admin       pubdate:2017-08-15 19:14

The fourth stage of diabetic nephropathy: clinical diabetic nephropathy or overt diabetic nephropathy. Characteristics of this period is macroalbuminuria (greater than 3.5 grams daily), edema and hypertension. Edema of diabetic nephropathy is more serious, the diuretic reaction. (a) for medical treatment of diabetes: 1. (1): the early diet therapy in favor of diabetic nephropathy should limit the intake of protein (0.8g/kg.d). The edema and renal insufficiency patients, in addition to limit sodium intake in the diet, the intake of protein should adopt the principle of concise (0.6g/ kg.d), when necessary, may be appropriate. In insulin and plasma amino acid transport guarantee may be appropriate to increase the carbohydrate intake to ensure sufficient heat. Fat should use vegetable oil. (2): drug treatment of oral hypoglycemic drugs. For simple diet and oral hypoglycemic agents are not well controlled and have renal insufficiency The patient as soon as possible the use of insulin. Insulin when blood glucose monitoring and timely adjustment of the dose. 2. antihypertensive treatment: hypertension can accelerate the development and progression of diabetic nephropathy, diabetic patients control blood pressure levels than nondiabetic patients with hypertension and low diastolic blood pressure less than 75mmHg. intake, should limit sodium to quit smoking, limit alcohol, weight loss and proper exercise. Antihypertensive drugs advocate the first choice of angiotensin converting enzyme inhibitor, often in combination with calcium antagonist, can also use alpha 1 adrenoceptor antagonists such as prazosin. Appropriate plus diuretics. (two) according to the condition of dialysis therapy for end-stage diabetic nephropathy patients only received dialysis treatment, there are mainly two kinds of methods: long-term hemodialysis and continuous ambulatory peritoneal dialysis. Most recently end-stage diabetic nephropathy patients using peritoneal dialysis, because it does not increase the load on the heart and Stress, can control the volume of extracellular fluid and high blood pressure. Also intraperitoneal injection of insulin, convenient operation and cost saving, but some patients due to long-term peritoneal dialysis absorb a large amount of glucose and obesity and high cholesterol. Regarding the timing of dialysis should be slightly earlier than the non diabetes patients. (three) kidney or kidney pancreas transplantation only a few patients this can get treatment for diabetic nephropathy. Therefore the most fundamental measures as well as possible control of diabetes to prevent the occurrence and development of diabetic nephropathy. About this disease prevention, prevention, prevention is the way it is not so, correction of all risk factors, including the control of blood glucose and blood pressure, smoking cessation in the microalbuminuria stage. First, the strict control of blood sugar can prevent renal disease. Modern medicine in treating diabetic nephropathy attaches great importance to blood glucose, blood pressure and other symptomatic measures. Hypoglycemic treatment, renal function in diabetes mellitus Not all patients preferred insulin, sometimes used oral antidiabetic drugs gliquidon, or combined with acarbose. Antihypertensive therapy, foreign study found that angiotensin-converting enzyme inhibitor Lotensin can delay the progress of renal failure in.2001 May 19th, the American Society of hypertension Sixteenth Annual Scientific Conference a report called "milepost" randomized, placebo-controlled study showed that angiotensin II receptor antagonist losartan in type 2 diabetic nephropathy, can be the final risk of ESRD or dialysis reduced 28%. other antihypertensive drugs such as calcium antagonists, beta blockers (such as metoprolol etc.) they may use. In addition, function diabetic nephropathy and renal insufficiency anemia, infection, heart failure, acid-base imbalance and electrolyte disturbance, then symptomatic treatment should be given accordingly. Diet is as follows: A, blood glucose control to lose. Blood sugar continues to rise, Will induce fatty cholesterol metabolism, promote renal glomerular capillaries. Intimal thickening hardened degeneration, the loss of normal function. The key is to control blood sugar strictly limit calorie intake, two is to adhere to medication, the king is to avoid emotional infection can lead to various factors of blood glucose fluctuation. Salt intake should be B. Limit. In order to protect the kidney, reduce the workload, patients with diabetes should be some light dishes, salt intake should be less than 7 grams per day, severe renal failure should also limit the intake of water intake. C, appropriate restrictions on potassium and protein. Because diabetic nephropathy prone to acidosis and hyperkalemia, once appear. The induced arrhythmia and hepatic coma, therefore, potassium potassium should drink, fruit intake should be controlled in C protein per kilogram of body weight per day 0.6 - 0.8 grams, and easy to digest fish, thin The meat is better, because the plant protein is not easy to absorb, will increase the burden on the kidneys. In addition, high potassium containing protein, protein intake to a certain extent, but also conducive to limit potassium. D, adequate intake of vitamins and trace elements. Especially vitamin B, vitamin C and zinc, calcium, iron, protecting effect the kidneys. Many kinds of trace elements in gold Vikam, proper proportion, easy to take one tablet daily. Vitamin E available to 11 international units of vitamin C daily, daily 0.3 grams, their volume slightly larger anyway.


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