Wednesday, July 3, 2013
Treatment of Diabetic Nephropathy
DN still has no effective therapy. The treatment principles are:1. To strictly control blood sugar to make the blood sugar close to the normal level, and prevent and delay the occurrence of DN; 2. to delay the rate of kidney function decrease;3.to treat with dialysis or kidney transplant.
Limit in protein intake. Proper reducing protein intake in food can decrease the intraglomerular pressure, high filtration and proteinuria. In contrast, high protein food may aggravate glomerular histological lesion. Patient with renal insufficiency should strictly control protein intake and take high quality protein containing essential amino-acid.
To strictly control glucose. Before occurring to clinical DN, use insulin pump or multiple subcutaneous insulin injection to control Diabetic Mellitus and keep the glucose the normal level, which can delay even prevent the occurrence and development of DN. It is good for other complications to lower the increasing GFR and improve microalbuminuria. According to The Diabetes Control and Complications Trial(DCCT) study, T1DM treated with insulin intensive treatment can reduce by 35%-55% of the occurrence rate for DN. Controlling glucose for the patients having developed into clinical DN and having obvious proteinuria is less useful for disease development. Hypoglycemic drugs will change into insulin after occurring to Clincial DN.
To control hypertension. Hypertension can accelerate the development of Renal Failure. The effective hypotensive treatment can slower the speed of GFR reduction and decrease the output of urinary albumin. Angiotensin coverting enzyme inhibitor or angiotensin Ⅱ receptor antagonist can be the first choice, and often used together with other hypotensive drugs, such as calcium antagonists, diuresis, β adrenergic receptor, methyldopa, and clonidine. If patients’ pressure is more than ≥130//80mmHg
Besides dialysis and kidney transplant, Micro-Chinese Medicine Osmotherapy is another treatment option when condition develops Kidney Failure. It can helps patients treat Diabetes and recover kidney function at the same time. If you need more, leave us a message or send us an email to doctornickzhang@hotmail.com.
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