Kidney failure can be caused by many factors, primary and secondary, hereditary and acquired. But the most common causes of renal failure are diabetes mellitus, hypertension and glomerulonephritis.
Here we mainly talk about some factors on diabetes and kidney failure problems. Diabetes is the most common cause of kidney damages and it accounts for about 35% of all chronic renal disease. Persistent high level of blood sugar will damage renal vessels and gradually reduce kidney functions and in the end lead to kidney failure without proper and timely treatments.
The following facts are some basic knowledge that you need to know and hope they can do some help to you.
1. Proteinuria is the most common symptom of diabetic renal disease. In the early stage it is microalcuminuria and 24-h protein loss in urine varies from 30-300mg. Along with illness progression, albumin excretion in urine will increase and it is called clinical diabetic nephropathy when daily urine loss in urine exceeds 500mg. The more protein is excreted, the faster the decline rate of Glomerular filtration rate. In most cases, it takes about 5-20 years to develop end stage renal failure since the onset of persistent proteinuria.
Therefore it is very necessary to have frequent and regular measurement of microalbuminuria so as to have early detection and prevent or at least slow down the progression into renal failure.
2. Hypertension, weather primary or secondary can speed up decline rate of kidney functions. Diabetes patients with high blood pressure will develop renal failure in shorter time that those that have normal blood pressure. Well controlling of hypertension can effectively reduce protein loss in urine, slow down illness progression and prolong patients’ life span.
ACEI and ARB drugs are the first choice for controlling high blood pressure. And other anti-hypertensive can be combined such as calcium channel blocker, diuretics, beta blocker, methyldopa, clonidine, etc. The ideal blood pressure for diabetic nephropathy patients should be below 130/80mmHg.
3. Kidney failure due to diabetes should begin dialysis earlier than other renal failure cases. Dialysis should be received when Ccr is 10-15ml/min. If patients have obvious uremic symptoms, dialysis should be started when Ccr is 15-20ml/min.
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