What is the first sign of diabetic nephropathy / diabetic kidney disease?
In the early stages, there are often no symptoms. The early sign of diabetic kidney disease is an increased excretion of albumin in the urine. We encourage everyone to have an annual check-up so that diabetic nephropathy (Figure 2) can be identified early on.

frequency
The prevalence of DN is mainly in type 2 diabetics, 20 to 40% of cases of microalbuminuria (AD) develop into manifest nephropathy 20 years after the onset of diabetes; About 20% develop end-stage renal disease (ESRD).

The risk of developing diabetic nephropathy (DN) begins with albuminuria and changes from microalbuminuria to macroalbuminuria. It is recommended that all type 2 diabetics have an annual urine test for microalbuminuria from the time of diagnosis. This prevalence ranged from 25% in patients under 65 to almost 50% in patients over 65 (22)

Symptoms

If kidney function worsens, these signs and symptoms suggest diabetic kidney disease:

Nausea, vomiting and loss of appetite
Anemia (low blood count)
Arterial hypertension
Morning sickness
High levels of BUN and creatinine in the blood
Difficulty sleeping or concentrating
Difficulty thinking clearly
Weightloss
feel like sleeping
Extremely dry and itchy skin
Muscle cramps (especially in the legs)
Weakness, pallor
Fluid retention in swollen feet and ankles
Swelling around the eyes
Urinate more often
Causes and risk factors
High blood sugar can damage the blood vessels in your kidneys because they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys.

Your risk for diabetic kidney disease is higher if you have type 1 or type 2 diabetes. A variety of other factors can increase your risk for developing diabetic kidney disease, including:

Smoke
High blood pressure (hypertension)
High cholesterol level (hypercholesterolemia)
High blood sugar (hyperglycemia)
A family history of kidney disease and diabetes
diagnostic
These tests and procedures can help determine if you have diabetic kidney disease, such as:

Blood tests. If you have diabetes, you will need blood tests to check your BUN and creatinine levels and monitor your condition to see if your kidneys are working.

Urine tests. Urine samples can indicate if you have too much protein in your urine. High levels of protein (microalbumin) can indicate that your kidneys are affected.

Imaging tests. X-rays and ultrasounds are recommended to assess the size and structure of your kidneys. In some cases, computed tomography and magnetic resonance imaging (MRI) scans are not recommended to help determine how well blood is flowing through your kidneys.

Kidney function test. to assess how well your kidneys are filtering using kidney tests.

Renal biopsy. After further diagnoses, the nephrologist may recommend a kidney biopsy to take a sample of kidney tissue. See kidney biopsy details here
How is diabetic kidney disease treated?
Medication: In the early stages of diabetic nephropathy, the treatment plan may include several medications to help control the causes:

Manage and control high blood sugar: Keep an eye on your blood sugar level to see why it is rising or falling. Eat regularly and don’t skip meals. Choose foods that are low in calories, saturated fat, trans fat, sugar and salt. Track your diet, alcohol consumption, and physical activity. Drink water instead of juice or soda.

Lower Cholesterol: Cut back on saturated fat, mostly found in red meat and high-fat dairy products, which can raise your total cholesterol. Eliminate trans fats; Eat foods rich in omega-3 fatty acids. Increase soluble fiber.

Urine protein albumin control: track dietary changes and try to maintain a healthy weight. Weight loss can treat conditions that have strange kidney function; Medicines for high blood pressure and diabetes can help control the amount of protein in the urine (proteinuria) and ultimately dialysis, which uses a machine to filter and purify the blood.

Maintain healthy bones: Consume plenty of calcium in your diet and exercise as part of your daily routine, take care

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