Diabetes mellitus edema treatment
Development and progression of kidney damage with diabetes mellitus e are a consequence of chronic hyperglycemia and high blood pressure.
The very first sign of disorders in the vessels of the kidneys is the appearance of an unusual amount of protein in the urine (microalbuminuria), which is detected by a special method. It is at this stage that there are no specific symptoms, blood pressure, as a rule, normal, there is no edema and pain.
In order to prevent the development ofdiabetic nephropathy, it is necessary to concentrate efforts on strict control of blood sugar level, reduce the intake of animal fats and start treatment even in the absence of symptoms.
With further progression of kidney damage. with urine will begin to be allocated a large numberprotein (macroalbuminuria or proteinuria), which is determined by routine urinalysis. The presence of protein in the urine testifies to the defeat of the kidneys, which in the future can lead to the development of renal failure. Patients develop swelling, blood pressure rises. The poisoning of the body develops with an increase in the level of creatinine in the blood, since the kidneys can not fulfill their function of purifying the blood.
- High blood sugar. The worse control of blood sugar is, the more likely it is for diabetic nephropathy to occur.
- Arterial hypertension.
- Duration of diabetes mellitus. The longer a patient has a disease, the greater the chance of developing kidney damage.
- Violation of lipid metabolism leads to the deposition of atherosclerotic plaques, in kidney vessels including, which contributes to the violation of their filtration ability.
- Smoking interferes with the normal functioning of the blood vessels of the kidneys, contributing to increased blood glucose levels.
- Genetic predisposition to the development of diabetic
GFR - glomerular filtration rate
PC - renal blood flow
From the onset of diabetes todevelopment stage nephropathy, is 10 - 25 years. The first three stages of the patient does not feel any changes, and the standard examination does not diagnose these stages.
To determine the stage of nephropathy apply also abridged classification.
- stage of microalbuminuria;
- the stage of proteinuria with preservation of the nitrogen excretory function of the kidneys (slags in the blood do not linger, but are excreted in the urine);
- the stage of chronic renal failure (slags with urine are not excreted and poison the body).
Chronic Renal Failure. in turn, has three stages:
- latent, or latent. Symptoms are absent.
- conservative. Characterized by increased fatigue, general weakness, decreased appetite, loss of body weight, dry mouth.
- clinical. There are headaches, ammonia odor from the mouth, the skin becomes dry, pale, flabby. The work of all organs worsens: the heart, nervous, respiratory system, gastrointestinal tract, etc. Most of the body's metabolic products are not excreted in the urine, but remain in the blood. This condition is called "uremia" (urine in the blood).
• Compensation of carbohydrate metabolism (HbA1c <7.0%) •Diet with moderate restriction of animal protein (1 g per 1 kg of body weight) • Use of ACE inhibitors (drugs that reduce blood pressure), even at normal blood pressure levels • Elimination of fat metabolism disorders
• Compensation of carbohydrate metabolism (HbA1c <7.0%) •Diet with restriction of animal protein (0.8 g protein per 1 kg body weight) and salt up to 3 g / day • Maintenance of blood pressure at the level of 130/80 mm Hg. Compulsory use of ACE inhibitors! • Elimination of disorders of fat metabolism
Chronic renal failure (conservative stage)
• Compensation of carbohydrate metabolism (HbA1c <7.0%) •Diet with restriction of animal protein (0.6 g per 1 kg of body weight), products rich in potassium and salt up to 2 g / day • Maintenance of blood pressure at the level of 130/80 mm Hg. • Continue taking ACE inhibitors at a reduced dose, with a blood creatinine level greater than 300 μmol / L - with caution, discuss with your doctor! • Combined antihypertensive therapy with mandatory use of potassium-eliminating diuretics • Treatment of anemia • Elimination of elevated levels of potassium in the blood • Elimination of phosphorus-calcium metabolism disorders • Use of sorbents
Chronic renal failure (terminal stage)
• Instrumental methods of blood purification • Kidney transplantation
To prevent the development and progression of diabetic nephropathy, it is necessary:
- It is hard to control the level of glucose in the blood and constantly maintain it in the range of 3.5-8 mmol / l.
- Constantly monitor blood pressure, not allowing it to rise more than 130/80 mm Hg. Art.
- Annually, and if possible, twice a year to conduct urinalysis in order to identify microalbuminuria.
- In the presence of proteinuria:
- do an analysis to detect the amount of protein in a daily portion of urine at least once a quarter;
- limit the use of kitchen salt;
- limit the use of animal protein to 0.6-0.8 g per 1 kg of body weight per day;
- to investigate the level of creatinine and urea in the blood serum 2 times a year for the detection of diabetic nephropathy.