In clinic, Diabetic Nephropathy can be divided into 5 stages. Among them, stage 3 is critical and the nephrotic sympoms appear such as micro-albumin. In this article, we will mainly introduce the third stage and the management of this stage.
The first stage is renal glomerular high filtration stage. GFR(glomerular filtration rate)increase, and the size of kidney becomes bigger are the main feature of this stage. Even patients who have been diagnosed with this disease just now can have this kind of change.
In the second stage, protein which is discharged into urine is normal. However, the structure of glomeruli in this stage is changed already. The membrane of renal glomerular capillary blood vessels increases.
In the third stage, UAE is continuously higher than 20~200ug/min. High filtration may be the main reason for continuous albumin. Of course, it is also due to the long time not control of metabolism. In this stage, blood pressure is a little high. Declining blood pressure can reduce the discharge of albumin to some degree.
In the fourth stage, the characteristic of Diabetic Nephropathy is large amount of protienuria. UAE is more than 200pg/min, which is nonselective proteinuria. With a lot of protein lost in urine, patients can have hypoproteinemia and edema, which form the typical characteristic of Diabetic Nephropathy. We can also consider the fourth stage as the prognosis of the third stage.
How to manage stage 3 of Diabetic Nephropathy? In this stage, the most urgent thing we should do is to control blood sugar and high blood pressure, which will worsen kidney damage if not treated well.
Firstly, control the intake of salt. A lot of research showed that too much salt can activate the amylase, which can promote the digestion of starch. In addition, it can also promote the absorption of free glucose, thus deteriorate the condition. To prevent high blood pressure, patients should control the intake of salt as well. Generally, the intake of salt should be less than 3 g in a day.
To treat high blood pressure in stage 3 of Diabetic Nephropathy, we should apply some Chinese medicine, which contains Chinese herbs and can improve the blood circulation, especially the micro-blood circulation. After the blood vessels are extended, blood stasis will disappear, thus relieving high blood pressure at the same time.
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