The treatment of diabetic nephropathy,diabetic nephropathy can live long2017-05-22 14:22
Strictly controlling blood sugar and keeping blood sugar close to the normal level can reduce the incidence of microalbuminuria and slow down the process of nephropathy. After the occurrence of renal dysfunction, the hypoglycemic drugs have special requirements.
(1) insulin needs to adjust the amount of insulin;
(2) after oral antidiabetic drugs, the change of metabolism in oral antidiabetic drugs occurred after the occurrence of renal insufficiency, and the drug should be selected and treated differently:
Sulfonylurea drugs are mainly excreted by the kidneys. When the renal failure, the accumulation of drugs in the body may induce hypoglycemia, and should be banned. But only 5% of Gliquidone metabolites excreted by the kidneys, so mild to moderate renal insufficiency can still be used. Drugs such as double guanidine drugs are mainly excreted by the kidney, and when the kidney fails, the accumulation of drugs in the body can lead to severe lactic acidosis, so it is forbidden. The a glucosidase inhibitor is absorbed only 1% to 2% after oral administration, and the rest can be taken out of the intestine and can be taken when the kidney fails. Thiazolidinediones and two ketones can be used in mild or moderate renal insufficiency. Nateglinide can be used in mild or moderate renal insufficiency.
actively control hypertension
When the urine protein is negative or less than 1 grams /24 hours, the target value of blood pressure control should be below 130/80mmHg. Patients with urinary protein levels greater than or equal to 1 g /24 h, preferably with blood pressure below 125/75mmHg, are important in reducing complications in diabetics, particularly in the control of diabetic nephropathy. The preferred antihypertensive drugs are class ACEI and class ARB drugs.
low protein diet
After the glomerular filtration rate decreased, the dietary protein intake was 0.6g/kg/d. Animal protein based, avoid crude protein, such as soy protein. In the implementation of low protein diet treatment, to prevent malnutrition occurs. The key to preventing malnutrition is to ensure that the patient has enough calories and can take the compound a- keto acid.
People with edema and hypertension limit sodium intake, ban smoking, limit alcohol consumption, reduce weight and proper exercise, regulate blood lipids, and treat anticoagulation.
Hemodialysis, peritoneal dialysis and renal transplantation are effective treatments for renal failure.
new advances in treatment
In recent years, the use of sulodexide and advanced glycation end products, protein kinase C antagonist, thiazolidine two ketones hypoglycemic agents, plant drugs, biological agents, gene therapy has become a research hotspot, some drugs are expected to be in the near future as new drugs in clinical treatment of diabetic nephropathy. However, there is no cure for diabetic nephropathy, so it is better to start with prevention.