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How to prevent and treat diabetic nephropathy

2017-05-28 10:35

Strictly control blood sugar, correct metabolic disorders: strictly control blood sugar and correct metabolic disorders, is the key to prevent and treat diabetic nephropathy.

Antihypertensive treatment: hypertension can accelerate the progression and deterioration of diabetic nephropathy. In order to improve this condition, it is important that antihypertensive treatment be achieved. For diabetic patients without renal impairment, blood pressure should be kept below 130/80mmHg; blood pressure should be controlled below 125/75mmHg if kidney damage or 24h urinary protein >1.0g are present. Angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists have been shown to retard progression of kidney disease. Often requires a combination of 2 or more than 2 kinds of antihypertensive drugs, can cause the blood pressure, and the combination is the most commonly used ACEI or ARB plus small doses of diuretics and (or) long-acting calcium channel blocker (CCB).

All patients with diabetes over the course of 5 years or more should be regularly checked for renal function, urinary protein characterization, 24 hours urine protein quantification, and pay attention to blood pressure and fundus examination. Urine albumin should be determined in case of early diabetic nephropathy. If it is determined to increase albumin and can exclude other factors which caused the increase of urinary tract infection, exercise, hypertension should be highly vigilant, should actively antihypertensive make blood pressure remained in the normal range, but also should emphasize low salt, low protein diet, high quality protein.

Urinary tract infections should be avoided: recurrent urinary tract infections may accelerate the progression of diabetic nephropathy.

Low protein diet treatment: in the context of diabetes, protein and amino acid components play an important role in the development and progression of diabetic nephropathy. Prolonged high protein diet may increase the high filtration status of the kidneys, while increasing the production and retention of toxic nitrogen metabolites in the body, resulting in further impairment of renal function. Therefore, we advocate limiting the amount of protein in the diet to reduce kidney damage. Generally advocated, the daily diet of protein, according to 0.6 ~ 0.8 grams / kg standard weight, to improve the quality of protein (meat, eggs, milk) ratio. In patients with diabetic nephropathy in the third, fourth phase, master the quality and quantity of daily protein intake, and balance, it may be beneficial to the recovery of the kidneys. Protein restriction should be more stringent when diabetic nephropathy develops into end-stage renal disease. Part of the wheat starch (extract, separate and remove the protein from wheat flour) was used as the main heat source instead of rice and flour. Because it contains a large amount of rice and flour and other staple foods in non high quality vegetable protein (each containing 4 grams of 50 grams), and plant protein content of wheat starch in little. Add essential amino acids or alpha keto acid when necessary.

Caloric intake: in low protein diet, the heat supply must be sufficient to maintain normal physiological needs. Daily intake of 30~35 kcal / kg body weight of heat energy. You can choose some staple foods high in calories and low protein content, such as potatoes, lotus root starch, vermicelli, taro, sweet potato, yam, pumpkin, water chestnut powder, water chestnut powder, total calorie intake reached the standard range. Ensure supply and demand balance. Insulin should be injected to ensure the use of sugar when necessary.

Adequate intake of vitamins and folic acid, reduce food intake of phosphorus: the appropriate supplement of vitamins is beneficial to the body to maintain normal metabolism and endocrine. Therefore, vitamin B, vitamin C and vitamin E should be properly supplemented. Vitamin E can be used to 0.3 grams per day, vitamin C 0.3 grams per day, and their amount is slightly larger, no harm. When renal damage occurs, the excretion of phosphorus decreases and leads to elevated blood phosphorus levels. What are usually of high calcium and high phosphorus, like animal offal, pork, shrimp, Zhuanggu powder like, is certainly high phosphorus, should not eat. Loss of vitamin D3 synthesis in patients with nephropathy, affect the absorption of calcium, calcium concentration in blood is reduced, prone to osteoporosis, so the ideal treatment should improve dietary calcium content, reduce the content of phosphorus. The low protein diet itself reduces phosphorus intake and is beneficial for treatment.

Other: the supply of fat depends on blood lipids; limiting salt intake can prevent progression of complications. But, if accompanied by vomiting and diarrhea at the same time, should not be too limited to sodium salt, and even need to add. Smoking cessation and proper exercise control, after the 4 stage of kidney disease, should not exercise a large amount of exercise, and can take a walk and other mild sports.

In short, diabetic nephropathy is a serious complication of diabetes, but as long as the confidence to overcome the disease, a healthy lifestyle and active treatment of diabetes, the correct metabolic disorder caused by diabetes, so early prevention and early diagnosis of diabetic nephropathy is not inevitable, diabetic patients have a healthy kidney is not only a dream.

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