Diabetic nephropathy is a specific kidney damage in diabetes mellitus, accompanied by the formation of nodular or diffuse glomerulosclerosis, the terminal stage of which is characterized by the development of chronic renal failure.
Diabetes mellitus is a socially significant disease. leads to a decrease in the quality of life, early disability and high mortality due to micro- and macrovascular complications, one of which is diabetic nephropathy.
According to various epidemiological studies, diabetic nephropathy occurs in 40-50% of diabetic patients with a disease duration of more than 20 years.
Changes in the kidneys occur from the first days of the disease. Symptoms depend on the stage of the disease. The following stages stand out.
- Asymptomatic stage - there are no clinical manifestations, but an increase in the glomerular filtration rate indicates the onset of a disturbance in kidney tissue.
- The stage of initial structural changes - there are first changes in the structure of the renal glomeruli (thickening of the capillary wall, expansion of the mesangium).
- The prenaphrophic stage - the level of microalbumin exceeds the norm (30-300 mg per day), but does not reach the level of proteinuria (either episodes of proteinuria are insignificant and short), blood flow and glomerular filtration is usually normal, but can be increased. There may be episodes of increased blood pressure.
- The nephrotic stage - proteinuria (protein in the urine) acquires a permanent character. Periodically, hematuria (blood in the urine) and cylinderuria can be noted. Reduced renal blood flow and glomerular filtration rate.
Arterial hypertension (increase in blood pressure) acquires a persistent character. There are edemas, anemia appears, a number of blood indicators are rising: ESR, cholesterol, alpha-2 and beta-globulins, beta-lipoproteins. The levels of creatinine and urea are slightly elevated or within the normal range.
Nephrosclerotic stage (uremic) - the filtration and concentration functions of the kidneys are sharply reduced, the levels of urea and creatinine are increased. Edema, proteinuria (protein in the urine), hematuria (blood in the urine), cylindruria, anemia, arterial hypertension. The level of blood glucose can be reduced. This stage is completed with chronic renal failure.
Angiotensin II receptor antagonists (AT1 subtype): Aprovel, Cosaar, Lozarel, Losartan-Richter, Lorista, Prezartan, and others.
ACE inhibitors: Capoten, captopril, Diroton, Lysigamma, lisinopril, Amprilan, Dilaprel, Korpil, Piramil, and others.
Angioprotectors and microcirculation correctors: Doxie-Hem, Actovegin et al.
Antihypoxants and antioxidants: Tiogamma, Espa-Lipon and others.
Detoxifying agents, including antidotes: R-IKS 1, etc.
Supplements: Radaklin, OMEGA PREMIUM ™ Life formula, etc.
Anticoagulants: Wessel Doué F, sulodexide, etc.
Vitamins and vitamin-like agents: Ascorbic acid, Neurorolip, Thiocacid 600 T, Tioctacid BV, Milgamma compositum, Vitakson, Kompligam B, Milgamma, Benfolipen etc.
Hepatoprotectors: Berlition 300 and others.