Diabetic Nephropathy generally exists among patients who have suffered from diabetes for more than ten years. Protein urine is the earliest warning of kidney problems.
Excessive intake of protein worsens the illness condition of diabetes. For patients with diabetes, the intake of carbohydrate is strictly limited. Some patients take more high-protein foods in order to guarantee enough energy intakes. However, excessive intake of high-protein foods leads to the accumulation of waste products of protein metabolism and phosphorus within the body, which give rise to further kidney damages.
Dysfunction of lipometabolism and atherosclerosis are the common complications of diabetes. And with the action of hypertension, damages to kidneys are common.
Long-term hyperglycemia increases the permeability of blood capillary. The leakage of plasma protein cause damages to basement membrane.
Diabetic Nephropathy can be categorized into five stages
The first stage is featured by increased GFR and the amplification of kidney size. The adoption of insulin treatment can reverse these symptoms, but usually they wont recover to normal standard.
In the second stage, there are some structural changes to glomerulus, such as the incrassation of glomerular blood capillary basement membrane and the proliferation of Mesangial matrix. Glomerular filtration rate is usually higher than normal standard. And important indexes are often that GFR>150mL/min, HBALC>9.5%, UAE>30ug/min. during the first and second stages, patients blood pressure is generally normal.
In the third stage, UAE is 20-200ug/min, and the patients blood pressure will slightly increase. and there is fading away of glomerulus.
The fourth stage is featured by large volume of protein urine. Edema, high blood pressure and urine albumin excretion being more than 3.5g per day are the common symptoms. Patient with diabetic nephropathy are not sensitive to diuretic, and the edema can be very serious.
The fifth stage is also the final stage. Continuous protein urine, wide range basement membrane incrassation and contraction of blood capillary lead to the fade way of more glomerulus, and as a result the glomerulus filtration rate decrease further more and causes renal failure.