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What Are The Symptoms Of Diabetic Nephropathy In Clinical

2018-09-10 15:04

Diabetic Nephropathy,In Clinical,SymptomsCore tips: Typical symptoms: proteinuria, glycosuria, islet cell destruction, ascites, loss of appetite; once persistent proteinuria, accompanied by loss of appetite, nausea and vomiting, anemia, suggesting that chronic renal insufficiency has occurred.

1. Symptoms

There is a history of diabetes, and the clinical manifestations of renal damage are positively correlated with the degree of glomerulosclerosis. When microalbuminuria occurs, the history of diabetes has been more than 5-6 years, clinical diagnosis of early diabetic nephropathy, without any clinical manifestations; about 80% of patients in 10 years to develop clinical diabetic nephropathy, that is, urinary protein content is more than 0.5g/24h, usually no significant hematuria, clinical manifestations of edema, hypertension; once the occurrence of persistent protein; Urine, accompanied by loss of appetite, nausea and vomiting, anemia, suggesting that chronic renal insufficiency has occurred.

2. Physical examination found

Different degrees of hypertension, edema, serious, can appear ascites, pleural effusion and so on. Combined with diabetic retinopathy.

3. Supplementary examination

Urinary glucose characterization is a simple method for screening diabetes mellitus, but it can appear false negative or false positive in diabetic nephropathy, so blood glucose measurement is the main basis for diagnosis.

Urinary albumin excretion rate (UAE) 20-200 ug/min, is an important indicator for the diagnosis of early diabetic nephropathy; when UAE persistently more than 200 ug/min or routine examination of urinary protein positive (urinary protein quantity is more than 0.5 g/24 h), that is, diabetic nephropathy is diagnosed. Urinary sediments generally do not change significantly, more white blood cells when suggesting urinary tract infection; a large number of red blood cells, suggesting that there may be other causes of hematuria.

In the late stage of diabetic nephropathy, endogenous creatinine clearance rate and blood urea nitrogen and creatinine decreased.

Increased radionuclide renal dynamic glomerular filtration rate (GFR) and enlarged renal volume measured by B-ultrasound are consistent with early diabetic nephropathy. In uremia, GFR decreased significantly, but renal volume did not decrease significantly.

Fundus examination, if necessary, fundus fluorescein angiography, we can see microaneurysm and other diabetic retinopathy.

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