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Should pay attention to the screening of diabetic nephropathy

Sep 13, 2017

Diabetic nephropathy is a clinical syndrome with multiple manifestations. The primary clinical feature is persistent albuminuria and progressive renal dysfunction as the condition progresses. So the screening of diabetic nephropathy is to cut into these two points to start.

First microalbuminuria, is the blood of albumin from the kidneys leak, can be detected in the urine. Due to the early amount of less, so the common urine is not easy to find, need to use a special method to detect the hair. Usually with random urine and 24h urine test in two ways. Random urine tests need to simultaneously detect the value of urinary creatinine, calculate the ratio of the two (urine microalbuminuria / creatinine, ACR). ACR> 30 mg / g or 24 h urinary albumin> 30 mg / h was considered abnormal. As the urinary protein excretion is affected by more factors, so often need to detect more than 2 times.

Followed by serum creatinine. The serum creatinine represents the condition of renal function. According to the guidelines published by the American Kidney Foundation, the MDRD formula can be used to calculate the value of glomerular filtration rate based on serum creatinine values. Estimation of glomerular filtration rate <90ml is considered to have mild renal function decline, 60-90ml for moderate renal function decline, <60ml is considered to be renal insufficiency.

Fundus photography. Diabetic retinopathy and nephropathy are associated with microvascular complications of diabetes. Check the fundus lesions can help identify the cause of kidney damage.

Urine routine testing. As the urinary tract infection can affect the detection of microalbuminuria, so the simultaneous detection of urine can help eliminate the factors caused by the illusion of infection.

In short, attention to diabetic nephropathy screening to help early detection of diabetic nephropathy patients, seize the timing of treatment to reduce the proportion of patients into the dialysis, to improve the prognosis of patients with diabetic nephropathy.

Should pay attention to the screening of diabetic nephropathy

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