How does diabetic nephropathy develop into uremia?2018-01-24 16:57
With the development of diabetes treatment methods and techniques, fewer and fewer patients died of acute diabetic complications such as ketoacidosis. In recent years, diabetes complicated by cardiovascular disease and kidney disease has become the leading cause of death in patients with diabetes. Diabetic nephropathy not only occurs in type 1 diabetes, but also develops into diabetic nephropathy in recent years.
Diabetes is a metabolic disease characterized by hyperglycemia. Hyperglycemia and metabolic disorders can lead to damage and failure of the whole body tissues and organs, especially the eyes, kidneys, cardiovascular and nervous system.
In general, according to the following 4 points, clinical consideration for diabetic nephropathy: more than 5 years of diabetes history; At this time, urine routine examination may be normal, must check urine trace protein or urinary protein creatinine ratio; Diabetic retinopathy; Exclude other causes of kidney disease.
With the improvement of people's living standard and the change of dietary structure, the probability of developing diabetes is increasing year by year. It is estimated that it will take a few years from the beginning of chronic nephropathy to uremia. Diabetic nephropathy can also be the first cause of uremia.
With the decline of renal function, renal insulin clearance also decreased. When GFR decreased to 40%, peritubular cells increased insulin uptake and degradation to maintain blood insulin levels. However, when GFR drops to 15 ~ 20 ml / min, it eventually leads to a decrease in insulin clearance.
In addition, spontaneous hypoglycemia can also occur in CRF. The decrease of insulin demand in diabetic patients is mainly found in the cases where the peripheral tissues are not significantly resistant to insulin, while the renal clearance of insulin has decreased significantly. Of course, CRF long-term inadequate eating, severe malnutrition when hypoglycemia can also occur.
After the occurrence of chronic renal failure, water and metabolic waste will be excreted, edema, metabolic acidosis, electrolyte disturbance, hypertension, anemia, calcium and phosphorus metabolism disorders will occur.
Uremia stage will appear a variety of organ function symptoms, a variety of diseases, such as: respiratory symptoms, gastrointestinal symptoms, blood system symptoms, neuromuscular system symptoms, bone lesions, cardiovascular system performance. All systems have unwell symptoms. Therefore, special attention should be paid to not allowing nephropathy, diabetic nephropathy to develop into uremia.