Diabetic nephropathy in patients with hypoglycemic2017-01-24 14:19
Diabetic nephropathy in patients with hypoglycemic: hypertension is impaired renal function of kidney patients, the development of the main factors, and controllable factors. So it is also for diabetic nephropathy. The role of hypertension, of considerable importance in the development of diabetic nephropathy so, control of blood pressure is the key to delay the development of diabetic nephropathy. Control of hypertension should first intake of sodium salt at the same time limit with smoking, drinking, body weight, proper exercise, this is the basis of treatment.
In patients with diabetic nephropathy and blood pressure should be controlled under 130/80mmHg. The data of blood pressure decreased from 160/100mmHg to 135/90mmHg, urine protein significantly reduced glomerular filtration rate the rate of decline from the monthly 1ml/min down to 0.35ml/min per month, diabetic nephropathy patients survival was also significantly prolonged antihypertensive treatment before l0 years cumulative mortality was 50% ~ 70%, confirmed the clinical study of effective antihypertensive therapy after 18%. treatment, the occurrence and development of diabetes can significantly prevent or delay of many chronic diseases. Studies show that active antihypertensive treatment, rate of progress can delay the clinical diabetic kidney disease, especially in blood pressure began to rise has not yet reached clinical hypertension is more obvious, antihypertensive therapy should be to reduce the mean arterial pressure, recovery of circadian rhythm of blood pressure and reduce glomerular pressure.
The choice of antihypertensive drugs is the first choice of angiotensin converting enzyme inhibitors, which can reduce the excretion of urinary protein and slow down the rate of decline of renal function:
(1) reduce the glomerular capillary pressure, thereby correcting the state of high filtration, but also reduce proteinuria, ACEI also can directly improve the selectivity of glomerular capillary filtration
(2) inhibit the activity of cell growth factors such as transforming growth factor beta, and increase the sensitivity of skeletal muscle insulin and improve the control of blood glucose
(3) reduce the phagocytosis of mesangial cells to macromolecular substances, thus reducing the proliferation of mesangial cells and tubulointerstitial fibrosis induced by proteinuria
(4) promote matrix metalloproteinase degradation, cell matrix has been formed to degrade.ACEI role not only for Buck, but not with hypertension in patients with diabetic nephropathy should be applied, and taking convenient, is the major side effect of cough. At present, the popular use of angiotensin converting enzyme inhibitor (ACEI) in the long term preparation.