How diabetes is the development of diabetic nephropathy? How to avoid the repeated of the disease?

How diabetes is the development of diabetic nephropathy? How to avoid the repeated of the disease? On this issue, this site has a very detailed scientific explanation, diabetes, kidney damage, the disease process is progressive, eventually developed into azotemia, uremia. .... Diabetic nephropathy is the first cause of end-stage renal failure. In the course of more than 15 years ... to develop into diabetes, diabetic nephropathy? How to avoid the disease repeated? More, see the following detailed description is:
Diabetes is the development of diabetic nephropathy in diabetic nephropathy, is the first cause of end-stage renal failure. Type 1 diabetes duration of more than 15 years of those, 30% ~ 40% of kidney disease. It is estimated that in type 2 diabetes among 25% of kidney disease, the majority of patients require long-term hemodialysis (approximately 60%) with type 2 diabetes. Regardless of the suffering from which type of diabetes, kidney disease in people with diabetes go through the five song ", or five points. Each phase of the performance of the following:
The first phase of
Manifestations of kidney volume increased, B-ultrasound kidney volume increased 25%.Increased glomerular filtration rate (GFR) (using the isotope method to detect), greater than 120 ml / min or 150 ml / min. The degree of blood glucose parallel. Renal biopsy was normal, not high blood pressure, seen in the early onset of diabetes. These reactions by strict control of blood glucose and insulin treatment a few weeks to several months after return to normal.
Phase II
Performance for the rest of the urinary albumin excretion increased, but after exercise the increase in urinary albumin. OK, such as treadmill exercise heart rate of 75% of maximum heart rate of their peers, for 20 minutes and one hour urinary albumin excretion of more than 20 micrograms / min. Glomerular filtration rate returned to near normal levels. If the patient continued filtration, too much means of diabetic nephropathy in high-risk status. This can also be reversed, not high blood pressure, renal biopsy to see the basement membrane thickening and mesangial matrix increase.
Phase III
Also known as early diabetic nephropathy. After exercise albuminuria into a persistent urinary albumin increased, reaching 20 to 200 micrograms / min, glomerular filtration rate remained relatively normal. At a later stage, blood pressure may be mildly elevated. If we do not actively take treatment measures, more than 90% of patients will develop significant diabetic nephropathy.
Phase IV
Obvious diabetic nephropathy, also known as clinical diabetic nephropathy period: this period of persistent proteinuria, the urine can be detected in urine protein, urinary protein excretion greater than 0.5 g / 24 hours, the equivalent of the urinary albumin excretion rate greater than 200 micrograms / min. Glomerular filtration rate, and patients with hypertension. If you do not control blood pressure, glomerular filtration rate with an average monthly decline of about 1.22 ml per minute speed deteriorating so that patients will be in 5-8 years development stage renal failure. Renal biopsy prompted glomerulosclerosis. This period, even after stringent treatment is irreversible.
Fifth
For end-stage diabetic nephropathy, blood pressure was significantly higher urinary protein does not like for other reasons as kidney disease due to renal failure in late decline, glomerular filtration rate up to 10 ml / min, blood urea nitrogen and creatinine l , edema and hypertension further increased, there hypoproteinemia. This period and more accompanied by diabetic retinopathy, diabetic neuropathy.