The pathogenesis of diabetic nephropathy

Diabetic nephropathy is much in the course of more than 10 years of diabetes, proteinuria is the earliest, diabetic nephropathy pathogenesis is complex, has not been fully elucidated.Research materials said the pathogenesis of diabetic nephropathy is multiple factors, mainly has the following several aspects:

1, mechanical abnormal renal blood activities: in diabetic nephropathy, play a key role, and perhaps even initiating factors.

(1) high blood sugar, high within the glomeruli, high filtration state, across the capillary wall pressure increase, expand mesangial cells, epithelial cell foot process fusion, and produce dense droplets, glomerular epithelial cells become detached from the basement membrane.

Collagen type (2) the glomerular basement membrane Ⅳ messenger sugar nucleic acid increased, the thickening of basement membrane, the ultimate form of mesangial clouded, nodular lesions, and glomerular sclerosis.

(3) in the case of increased pressure, increase protein filtration, can precipitate in mesangial area and glomerular basement membrane, promote stromal hyperplasia, form a vicious cycle, and can cause nodular and clouded glomerular sclerosis.

2, hyperglycemia: diabetic nephropathy in closely related to high blood sugar, poor blood glucose control can accelerate the progress of diabetic nephropathy, good blood glucose control can obviously delay its progress.High blood sugar, glycosylation end-products of natural increase caused by mesangial cell proliferation and extracellular matrix increased, mesangial expansion and glomerular basement membrane thickening, etc.

3, genetic factors: most patients with diabetes ultimate not happen kidney disease changes, some long-term blood sugar control good also can appear in patients with diabetic nephropathy.Glucose transporter protein 1 (GLUT1) on glomerular mesangial cells is the main glucose transporter.Recent studies have found that people with diabetes between different individual GLUT1 menu of mesangial cells and regulating the differences are likely to be some patients are predisposed to kidney damage.And the occurrence of diabetic nephropathy also show the family condensation phenomenon, and in some patients with a family history of high blood pressure, diabetes, the incidence of diabetic nephropathy is significantly higher than that of without a family history of hypertension patients.In addition, between different ethnic groups there are differences in prevalence of diabetic nephropathy.It showed that the occurrence of diabetic nephropathy is associated with genetic factors.


4, high blood pressure, and there is no direct relationship between diabetic nephropathy in, but the original hypertension or blood pressure when in the course of the disease to microalbuminuria period after can accelerate the progress of diabetic nephropathy and the deterioration of renal function, increase the excretion of urine albumin.

Four Major Complications with Lupus Nephritis

With lupus nephritis will not only bring great impact to the patient's psychological, will also bring serious damage in the body, and cause a series of complications, a serious threat to the health of the patient.In order to let you have more understanding of the side effects with lupus nephritis, explain with lupus nephritis complications for everyone.

The gastrointestinal system

Li Qiujie division director, points out that with lupus nephritis can cause gastrointestinal complications, part of the patient may be accompanied by abdominal pain, this is mainly related with vasculitis lesions caused by abdominal organs.Some patients will show that the liver and spleen enlargement, also may represent ascites.Kidney disease expert reminds, show with lupus nephritis, be sure to do a good job in renal function, routine urine examination and comprehensive inspection.

The cardiovascular system

A subset of patients will produce pericarditis, usually short and mild, and the performance of some patients with myocarditis, about a quarter of patients may show the Renault phenomenon.Kidney disease expert reminds, with lupus nephritis caused by complications of cardiovascular system side effects to the human body is great, so, in the early onset with lupus nephritis, be sure to take time for treatment, away from the burden to heal.

The blood system

Li Qiujie of display, about half of the patients with lupus nephritis were positively pigment cell anemia, and also showed leukocytosis rest.Kidney disease expert reminds, when patients showed anemia performance or leukocytosis, make sure not to sloppy, take the time to normal hospital check, heal, to control the development of the disease, is the key.


At present, the more effective way of treating with lupus nephritis is the people's hospital of chengdu jinjiang renal medicine "characteristics of traditional Chinese medicine osmosis therapy", traditional Chinese medicine for external use, save energy, ziyin yangxue, centralizer tonify deficiency, improve patient resistance, make patient from kidney disease.

What are The Complications of Uremia

Early uremia is not without any clues, kidney patients should pay attention to several not obvious signs of uremia, in a timely manner to the hospital blood test the indicators of renal function, can be a definitive diagnosis.In addition to kidney disease, high blood pressure, diabetes patients should be regular physical examination as soon as possible, see if routine urine and kidney function is normal, if it is found that index to exceed bid, must timely medical treatment.

Kidney disease hospital, experts say, was badly damaged by kidney function in patients with uremia period, the body will appear different complications.If people of uremia are not familiar with, do not know, might've picked department cure uremia patients, and delayed the time of the uremia treatment.

1. The itchy skin.Easily misdiagnosed as neurological pruritus.

2. The digestive system complications.Uremia period, kidney disease can appear nausea and vomiting, hiccups, vomiting blood, or stool, anorexia, diarrhea, when these symptoms appear may think you have bad stomach and attendance in the digestive department, some doctors will also be misdiagnosed patients for hepatitis, dysentery, gastritis, peptic ulcer or bleeding, gastroenteritis.

3. The skeletal system complications.Osteomalacia, bone sclerosis, fibrous osteitis easily misdiagnosed as arthritis;Renal rickets is easily misdiagnosed as benign rickets nutrition.

4. The blood system complications.Anemia is easily misdiagnosed as iron deficiency anemia, aplastic anemia;Epistaxis is easily misdiagnosed as epidemic hemorrhagic fever;Easily misdiagnosed as thrombocytopenic purpura, allergic skin purpura violet scar.

5. Complications of neuromuscular system.Drowsiness, coma, coma is easily misdiagnosed as hepatic coma;Paresthesia is easily misdiagnosed as peripheral neuritis;Insomnia, depression, attention deficit is easily misdiagnosed as neurosis;Hallucinations, psychosis is easily misdiagnosed as mental illness;Epilepsy is easily misdiagnosed as primary epilepsy.

6. Cardiovascular respiratory complications.
High blood pressure is easily misdiagnosed as primary hypertension;Left heart failure easily misdiagnosed as coronary heart disease (CHD), hypertensive heart disease;Difficulty in breathing easily misdiagnosed as lung;Respiratory acidosis sex easily misdiagnosed as chronic bronchitis with acute infection;Uremia is easily misdiagnosed as lung bronchiectasis, bronchial asthma.

7. Co-infection.Infection is easily misdiagnosed as general bacterial infections.

8. Urinary tract complications.Urine is easily misdiagnosed as diabetes;Nocturia more easily misdiagnosed as neurogenic urine.


According to data shows, the United States in 2009 people with chronic kidney disease 11.5%, Japan's population prevalence of chronic kidney disease was 13%, while the same chronic kidney disease (CKD), but the process of our age and pathological changes of has obvious differences with abroad.For prevent uremia, as a doctor should do an own strength, enrich their knowledge, can clear diagnosis, will kill it in the bud, promote disease common sense, is we should do our duty.

The Best Way to Prevent Diabetic Nephropathy

Primary prevention: nonselective prevention is for the whole population, mainly is the change of environmental factors and lifestyle, will lead to diabetic nephropathy of various factors to a minimum.The occurrence of diabetic nephropathy and excessive calorie intake, nutrition surplus, obesity and other factors, such as lack of exercise is closely related, so should pay attention to reduce calorie intake in their daily lives, to develop "three low" high (low salt, low sugar, low fat, high fiber), eating habits, eat more fresh vegetables and fruits, don't eat too fine flour, eat more whole grains, in addition to doing moderate physical exercise a day.

Secondary prevention: people at high risk for type 2 diabetic nephropathy (including diabetic kidney disease family history, hypertension, hyperlipidemia, obesity and over 40 gestational diabetes nephropathy, etc.) to regularly test blood sugar, in the early detection of negative type 2 diabetic nephropathy (that is, only patients with elevated blood sugar and no obvious symptoms) and decreased glucose tolerance, early detection, early treatment.Decreased glucose tolerance is also known as "the early stage of the diabetic nephropathy," refers to blood sugar above normal, but has yet to reach the diagnosis of diabetic nephropathy standards, this part of the patients through diet or medication may become normal, if not add control may develop for diabetic nephropathy.

Tertiary prevention: diabetic nephropathy if can not get good control for a long time, can also cause heart, brain, kidney, nerve, critical organs such as eye complications, and even lead to disability or death.Tertiary prevention is in patients with diabetic nephropathy has been diagnosed through diet therapy, exercise therapy, drug therapy, psychological treatment, a variety of means such as diabetic nephropathy education, strive to achieve prevent or delay the complications of diabetic nephropathy (mainly) chronic complications occurrence and development, in order to maximize the ease the pain of the patients with diabetic nephropathy, improve the quality of life of patients.

Both diabetes and diabetic nephropathy early, in view of the disease treatment is the key of itself, that is to say, the first thing to block the patient's body of insulin resistance, repair susceptibility genes, the damaged pancreas tissue repair in place can have the effect of lowering blood sugar, fundamentally from blood sugar again to the kidneys, so as to achieve the effect of the treatment of diabetic nephropathy.

The Self-help Nursing Methods of Kidney Failure

Now people gradually realized the severity of kidney failure.If not treated
patients, likely to cause serious consequences.Therefore, timely treatment and
reasonable treatment, renal failure patients learn to self care methods!

Kidney failure self care, pay attention to exercise and rest

Kidney disease is a disease cannot overworked, can according to oneself
circumstance in the process of treatment for a walk or do some appropriate
gymnastics, in order to keep healthy, enhance resistance;Also can see some
useful books, spend time at the same time, strengthen their confidence to
overcome the pain and perseverance.

Kidney failure self-care, light diet

So-called diet light, that is, low sodium, low potassium, low fat food.In
patients with renal failure, electrolyte disorders, kidney function is not
strong, the amount of salt and fat, not only the burden will add to the kidney
also affects other viscera, cause other complications.

Kidney failure self care, diet and nutrition

How is light and nutrition diet?Patients should choose some nutrition is rich,
but you low-fat protein foods, such as milk and eggs.But if the patient began
to do dialysis, should follow the nutritionist's suggestion, reasonable
collocation, in order to prevent malnutrition.

Kidney failure self care, pay attention to life

Patients with kidney failure, in order to more effectively enhance the
treatment effect, life still need notices: such as cold warm, avoid hurt,
regular work and rest, pay attention to the details of the abnormal body, and
so on.Every patient, only you smile to the life, love your body, life will

smile back, good health!

Bad Habits Lead to Kidney Damage

Now the incidence of kidney disease has become more and more high, in order to
protect the kidney, we should correct some bad habits of life.

1.Abuse of pain relievers that long-term high-dose or take some anti-
inflammatory analgesic drugs, such as amidopyrine and phenacetin compound
tablet, indomethacin, acetaminophen, aspirin, easy to cause damage to the
kidney.

2.An overdose of some Chinese herbal medicine: clinical findings will "kidney"
of Chinese herbal medicine has: tripterygium wilfordii, also, semen
pharbitidis, fructus xanthii, opium poppy, sward, Rangoon creeper, radix
aristolochiae, wide oneself, etc.The tripterygium wilfordii renal damage
caused by the largest, the second is also given.

3. Overeating, modern dinners opportunities increased, often eat too much
"delicious", most of these wastes through the kidneys, dietary excesses will
no doubt increase the burden of the kidney.

4. Often a full bladder, some people because of work busy and full bladder for
a long time.The expert reminds a full bladder can lead to urinary tract
infection and acute pyelonephritis.These infections once break out repeatedly,
can cause chronic infection, is not easy to cure.

5. Too little water, if long time don't drink water, urine volume will reduce,
carrying waste and toxins in the urine concentration will increase.Clinical
common kidney stones and kidney seeper, etc are closely related, and long time
without water.

6. Excessive drinks, soft drinks and sports drinks the excessive intake of
indirect damage to the kidney.The ph value of 7.2 in the human body, the
drinks generally is highly acidic, after drinking the body ph change
obviously.

7. Too soft bread, bread and cakes have a kind of food additives, potassium
bromate in taste taste soft, but excessive consumption will harm people's
central nervous system, blood and kidney.

8. Drink strong tea: some people think that drink can solution wine to drink
strong tea, it not only invalid, kidney damage.Experts said that theophylline
in tea can affect kidney and quickly give play to the role of diuresis, even
before the alcohol decomposition again from the kidneys and cause your kidneys
to stimulation by a large amount of ethanol, and damage to kidney function.

9. Too salty diet: eating salty, causing blood pressure to rise, unable to

maintain normal renal blood flow, so as to induce kidney disease.

Hypertensive Nephropathy Damage Factors

Benign arteriolar nephrosclerosis Department of essential hypertension hypertensive nephropathy caused (also known as hypertension, renal arteriosclerosis) and malignant renal arteries harden, and accompanied by appropriate clinical manifestations of the disease.

Factors which hypertensive renal damage 

First, the severity of the incidence of hypertension and hypertensive renal damage and the duration was positively correlated. Other possible factors include gender, race, diabetes, hyperlipidemia and hyperuricemia, these factors influence each other, and further aggravate kidney damage. Men are more likely than women with renal impairment. Age of onset of essential hypertension is generally 25 - 45 years old, and kidney damage caused by hypertension clinical symptoms of age is generally 40 - 60 years old.

Second, the earliest symptoms of nocturia may reflect the renal tubules has occurred ischemic lesions, urine concentration function began to subside. Then proteinuria, indicating glomerular lesions has occurred. The degree of proteinuria is usually mild to moderate (+ or + +), 24-hour urinary protein excretion is generally not more than 2 grams, but a few patients with macroalbuminuria. Urine microscopic examination of red blood cells and casts little individual patients because the glomerular capillary rupture transient hematuria. Research has shown that there are ten thousandth will develop renal failure in patients with essential hypertension and renal function in patients with untreated hypertension were significantly lower than those without hypertension.

Third, can often be found in other organs essential hypertension caused mainly cardiovascular complications, these complications may occur earlier than kidney damage, the condition is more serious, as the main or key prognostic factors. The most common cardiac complications are hypertensive left ventricular hypertrophy, and easy to merge heart failure, angina pectoris; cerebrovascular complications of cerebral hemorrhage and cerebral infarction, essential hypertension causes of accidental death at home in our cerebrovascular the first place.

Four, hypertension can also cause retinal arteriosclerosis, further causing arteriosclerotic retinopathy. Retina and blood pressure is proportional to the degree of atherosclerosis, in which the relationship between diastolic blood pressure more closely. Retinal and renal sclerosis is generally parallel to the degree of atherosclerosis, renal artery can be broadly reflect the situation, it is very important fundus examination.