Thursday 5 July 2012

Life Expectancy of stage 3 diabetic nephropathy


A long-term effective control of diabetes: high blood sugar is the basic factors for the development of diabetic nephropathy, early detection of diabetes and proper treatment of the as much as possible so that the three substances metabolism back to normal is critical. Control the blood sugar at normal levels, often make the early pathological changes to restore, but of such progress to clinical renal play, even if the strict control of blood glucose, the effect is also poor. Close to uremia of diabetic nephropathy can occur the following phenomena: (1) Renal sugar group clearly increased, it is not urine to determine the degree of glycemic control, the surface should be subject to the determination of blood garnet, increased the difficulty of the conditioning dose of insulin and hypoglycemic agents ; ② certain metabolites in uremic fatigue reducing, caused by the use of copper sulfate reduction assay urine false positive; ③ The uremic patients loss of appetite, eating less, even take the kidney itself off can decline to insulin, reduce insulin requirements, and prone to hypoglycemia should be readily conditioning dose; ④ generally not suitable for re-use of oral hypoglycemic agents, the surface should be used insulin. Oral hypoglycemic agents can be used with caution worse diabetes non-insulin-dependent diabetes. Biguanide easy to induce lactic acidosis, should not be used; tolbutamide (D860) and sugar Fit is safer, but there are reports of hypoglycemia, the application still need to be closely observed.
Two, the positive treatment of hypertension: antihypertensive treatment is very important for the slow rate of decline of glomerular filtration rate. Blood pressure control, proteinuria discharge also decreased. Make the blood pressure dropped to 16.8/l1.5 kPa (126/80mm Hg), and in that time to treat high blood pressure is more important than the treatment of high blood sugar, but both at the same time. Have favored nephropathy selected angiotensin converting enzyme inhibitors, the preparation turned into angiotensin II by inhibiting angiotensin Ⅰ, so that sodium retention to reduce the blood vessels to dilate peripheral resistance decreased, so that the drop in blood pressure. In addition, because the glomerular human ball, efferent artery dilatation, glomerular improve the blood supply, thereby reducing the glomerular progressive damage and improved renal function, commonly used drugs Capoten, said Ning sneeze can also be used nifedipine, the group of Nepalese peace, compound antihypertensive tablets and other treatment.
Third, adjust your diet: reducing protein intake, not only for renal insufficiency favorable, but also help to reduce the emission of proteinuria. The daily protein intake does not exceed 30 to 40 grams. Selection of high quality protein, such as milk, eggs, meat. Soy products and so should be limited.
Dialysis and transplantation: garnet urine disease of kidney disease uremia should be carried out peritoneal or hemodialysis treatment. Kidney or pancreas - kidney transplantation for the treatment of diabetic kidney late the most effective way. After transplantation, allows glycosylation of hemoglobin and serum creatinine, phenol levels return to normal.
Fifth, do not use harmful drugs: the kidneys, such as gentamicin, streptomycin, amikacin, neomycin, etc..

1 comment:

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