The Best Time for Treating Diabetic Nephropathy

Diabetic Nephropathy is one of the most common complications of Diabetes. It is also a major cause of death in patients with Diabetes. When it is caught in the early stages, its progression may be slowed with treatment. Once large amounts of protein appear in the urine, the patients' condition will slowly get worse. Often, it will lead to Kidney Failure. Therefore, choosing the best time for treating Diabetic Nephropathy is of great importance. Then, when is the time for treating Diabetic Nephropathy?
Actually, in treating Diabetic Nephropathy, the earlier the treatment is, the better the curative effect will be, for with the worsening of the kidney damages, the treatment and the prognosis will correspondingly become more difficult.
Both the occurrence and the development of Diabetic Nephropathy are the process of the accumulation of kidney damages. Clinically, Diabetic Nephropathy can be divided into five stages. Generally, if the blood sugar did not get good control, Type 1 Diabetes will progress one stage every five years, while Type 2 Diabetes will progress one stage every three or four years.
Stage 1 to Stage 3 all belong to the early stage of Diabetic Nephropathy. In these three stages, usually there is no symptoms. If effective treatment can be adopted in these stages, Stage 1 Diabetic Nephropathy can be cured, while the progression of Stage 2 or 3 Diabetic Nephropathy can be obviously suppressed. In stage 1, only the glomerular filtration rate(GFR) increases, therefore, if the blood sugar can be controlled well, the patients' condition can be reversed. In stage 2 and 3, microalbumin will occur in the urine. If the microalbumin only occurs after exercise, fever or in other stress state, it is stage 2 Diabetic Nephropathy; if the microalbumin occurs persistently, it is stage 3 Diabetic Nephropathy. In treating stage 2 and 3 Diabetic Nephropathy, apart from controlling the blood sugar, angiotensin converting enzyme inhibitor(ACEI) and angiotensin receptor blockers(ARB) should also be adopted.
By urine routine test, if the urine protein is positive, it indicates the coming of stage 4 Diabetic Nephropathy. In this stage, the urine protein will increase and finally form large quantities of proteinuria(the urine protein is more than 3.5 g/d), which will lead to hypoproteinemia, edema and hyperlipidemia. That is to say, patients with stage 4 Diabetic Nephropathy will have Nephrotic Syndrome, often with hypertension. At this time, the renal function will get worse quickly. And as for treatment, it is mainly symptomatic treatment, including limiting the salt intake, promoting the urination, lower the blood pressure and regulating the blood lipid.
If the patients' condition continue to worsen, it will develop into the stage 5 Diabetic Nephropathy—the Kidney Failure period. In this stage, the patients will have poor appetite, nausea, vomit and other symptoms, and their serum creatinine and blood urea nitrogen will increase. And finally, in order to sustain life, dialysis will be necessary for some patients.
From the above, we can conclude that stage 1 to stage 3 is the best time for prolonging the progression of Diabetic Nephropathy.