[Pu people and convenience] The culprit of kidney disease "diabetes" prevents early prevention and early treatment, so that the kidney is safe

The prevalence of chronic kidney disease in China is 10.8%, and hundreds of millions of people in my country have chronic kidney disease; the total prevalence of adult diabetes in China is 12.8%, and there are about 120 million diabetic patients in my country. In other words, the number of patients with chronic kidney disease in my country is not much less than those with diabetes. But in people's knowledge, people with diabetes are everywhere, but there are not many patients with chronic kidney, and people generally ignore the existence of chronic kidney disease. In order to help people understand the kidneys, understand kidney disease, and avoid misunderstanding, today we talk about diabetic nephropathy.

Why do you introduce the diabetic and kidney disease alone?

Because diabetes has become the "culprit" that endangers the kidneys. Data show that nearly a quarter of patients with chronic kidney disease in the United States are caused by diabetes. 38%of patients with uremia are developed from diabetic nephropathy. Diabetic nephropathy is the first cause of dialysis patients. More than half of patients with uremia in Spain are patients with diabetic nephropathy. In Japan and Taiwan, this proportion is also as high as 28%and 26%. In China, according to the statistics of the 2019 Chinese Medical Society's kidney disease: the proportion of diabetic nephropathy in patients in my country has reached 13.5%, exceeding hypertension nephropathy. Cause. It is expected that in the near future, diabetic nephropathy will surpass glomerular nephritis, becoming the largest primary disease of patients with dialysis in China. Diabetic nephropathy is a problem that patients with diabetes must pay attention to.

What is diabetic nephropathy?

According to the clinical diagnosis of NKF-KDOQI diabetes and kidney disease in 2007, the following situations are often diagnosed as diabetes and kidney disease:

● Diabetes have a large amount of albumin urine.

Or in the following situations, there is a small amount of albuminuria:

● Diabetic retinopathy;

● Type 1 diabetes course for more than 10 years.

That is

● A large amount of protein urine in people with diabetes is diabetes and nephropathy;

● Diabetes have trace proteinuria, and at the same time, diabetic retinopathy is also considered as diabetic nephropathy;

● Or a trace proteinuria of type 1 diabetes in more than 10 years is also considered as diabetic nephropathy.

Is it necessary for diabetic urine to have diabetic nephropathy?

Patients with diabetes are diabetic nephropathy, or non -diabetic nephropathy (primary glomerular nephritis), or coexistence of diabetic nephropathy with non -diabetic nephropathy. The clearest identification is to do nephrologically examination through kidney puncture.

Any one of the following situations should be diagnosed as soon as possible with kidney puncture:

● The history of diabetes is less than 5 years;

● First with kidney damage (proteinuria), then diabetes, or diabetes and kidney damage at the same time;

● Renal hematuria;

● There is kidney damage, but there is no diabetic retinopathy;

● At the beginning of the onset, a large amount of proteinuria (urine protein quantity ≥3.5g/L).

Nephrine biopsy is a gold standard diagnosis of diabetic nephropathy and identifying non -diabetic nephropathy. The treatment of diabetic nephropathy and diabetes combined with primary glomerular nephritis is completely different. The diagnosis is more targeted to treat. If diabetic patients have proteinuria, but there is no diabetic retinopathy and cannot be diagnosed with kidney puncture, it can be diagnosed as diabetes with chronic kidney disease.

What are the non -drug intervention measures for diabetes with kidney disease?

Non -drug measures for diabetes with kidney disease, including diabetes self -management and education, lifestyle intervention, weight loss, smoking quitting, alcohol restrictions, blood pressure, fat regulation, anti -platelet treatment, etc. to maximize renal of kidney disease and cardiovascular vessel Disease events and risk of death.

How to properly treat hypoglycemic treatment with diabetic nephropathy? Do I have to use insulin treatment?

● If the pathology is diagnosed with primary glomerular nephritis such as IgA nephropathy and membrane nephropathy, according to the pathological results, hormones may be selected or combined with immunosuppressants at the same time. Hormones can cause significantly increased blood sugar and increase diabetes. Therefore, at the same time as hormone therapy, hypoglycemic treatment should be strengthened.

● If it is clearly a simple diabetic nephropathy, it is necessary to strictly control blood sugar. In terms of choice of hypoglycemic drugs, diabetic nephropathy should be avoided as much as possible with hypoglycemic drugs that are excreted through kidney and at the same time.

● The most common side effects of insulin therapy are insulin resistance, which almost run through the entire process of developing type 2 diabetes. It also exists in patients with type 1 diabetes and has an important impact on the occurrence of type 1 diabetes complications. Insulin resistance is the decline in sensitivity of human cells and tissue to insulin, and insulin resistance increases the difficulty of blood glucose management. The glucose in the blood cannot be effectively transformed by the liver, muscle and fat cells. Vascular, eye, kidney, and nerve tissue and other tissue organs have chronic developmental lesions; secondly, insulin is mainly through renal tube metabolism, and insulin accumulation may occur in the body after renal dysfunction, and insulin resistance may cause hypoglycemia side effects to be obvious. Especially those with renal dysfunction should strictly grasp the timing, methods and dosage of insulin use.

Can Chinese medicine treat diabetic nephropathy?

In recent years, many domestic and western medicine experts in China have concentrated on studying Chinese medicine to prevent diabetic nephropathy, and the results and results of research are significant. The methods of treating diabetic nephropathy in Chinese medicine are:

● Through traditional Chinese medicine treatment, it can improve clinical symptoms, regulate lipid metabolism, control weight, improve glomerular filtration rate, reduce urine protein, protect renal function, and improve nutrition; , Ear acupoint press beans, acupuncture, traditional Chinese medicine foot bath and other improving kidney circulation, reducing the edema and peripheral neuropathy of the limbs;

● Traditional Chinese medicine ion import and traditional Chinese medicine packet can increase glomerular filtration rate, improve the metabolism of renal tubes, and reduce insulin resistance;

● The use of traditional Chinese medicine enema and traditional Chinese medicine can prevent diabetic nephropathy complications in late -late -stage uremia.

The study of modern pharmacological studies has confirmed that the main ingredients in astragalus are saponin, flavonoids, and polysaccharides. It is found that the saponin and flavonoids in it have significant reduction of blood sugar and delay the effects of chronic kidney disease.

● Poria ingredients Poria ingredients to activate AMPK and PI3K to show the adjustment effect of insulin -like transposition of GLUT4 membrane to achieve the effect of reducing blood sugar and found that they can be used to treat diabetes;

● The low polysaccharide component in the wheat martial winter can be effectively used to relieve symptoms of type 2 diabetic nephropathy;

● Schisandra extract can inhibit diabetes and nephropathy nephropathy, maintaining foot cell integrity, protecting medicinal renal toxic damage, etc.;

● Raw ground yellow and its extracts have the function of improving the function of islet β cells, reducing the level of blood insulin resistance, regulating the balance of cell glucose itself, reducing the role of liver glucose-6-phosphatase activity to improve lipid metabolism disorders and renal function;

● Snow grass can inhibit fibroblast proliferation, prevent adhesion, relieve adhesion formation, reduce blood lipids, urine protein, reduce kidney pathological damage, and have the effect of anti -glomerular sclerosis. The role of high filtering state;

● Puerasein can reduce the excretion rate of urea nitrogen, serum creatinine, and 24 H urine albumin excretion rate of diabetic nephropathy, increase the endoscopic removal rate, and reduce endothelin expression significantly, indicating that Puerase has an exact renal protection effect.

Method of DN the treatment of Chinese medicine dietary treatment:

30g of Pueraria powder, 1000g of japonica rice, wash the slices with Fgragia, grind the water and grind it to precipitate, take the starch and dry it to get the pueraria powder, wash the rice, add the amount of water, boil on high heat, change the heat for 30 minutes, add Puessing Puessing, add Puessing Powder, cook until rice cooked into porridge. Eat January in the morning and evening.

30g of yellow essence, 15g in Beisha Ginseng, 30g of Huai yam, 30g of Yuzhu, 1 pig pancreas. Usage: Remove the oil film of the pig pancreas and wash it; put the above drugs in the clay pot, add an appropriate amount of water, cook for 1 hour on low heat, season, drink soup with amount of soup, and eat pig pancreas.

Introduction

Jin Zhouhui

Chief physician, part -time professor at Anhui Medical University

Expert special disease clinic time: Tuesday morning (expert), every Thursday morning (diabetic nephropathy)

Director of the Department of Traditional Chinese Medicine, Director of the Teaching and Research Office of Traditional Chinese Medicine, a famous Chinese medicine medicine in Pudong New District, and a leader in the subject of diabetes and nephropathy in Pudong New District. Good at the combination of Chinese and Western medicine with diabetic nephropathy, diabetic retinopathy, diabetic foot, diabetic peripheral neuropathy, diabetic insulin resistance, and complex urinary tract infection, chronic renal failure.

King

Indicator of the Communist Party of China, a master of Chinese medicine

Explorest time: Thursday morning

Pudong New Area Famous Traditional Chinese Medicine Studio, the Double Employment Disease (Cervical and Underworld) of Shuguang Hospital of Shanghai University of Traditional Chinese Medicine (neck and back pain) joint doctor.

Good at: needle medicine combined with the treatment of metabolic syndrome, obesity, dizziness, migraine, insomnia, stroke and other diseases.

Pan Yuanwei

Indications, doctor of medicine

Explorest time: Tuesday afternoon, every Thursday morning

The teaching secretary of the teaching and research room of the Chinese Medicine, the inheritance of the famous Chinese medicine studio in Pudong New District, and Youqing, Pudong New District.

Good at: combined Chinese and Western medicine to treat diabetic nephropathy, uric acid nephropathy, hyperuricemia, gout, and hepatitis B -related nephropathy, digestive system tumor, etc. The use of traditional Chinese medicine comprehensive therapy to treat unsatisfactory menstruation, lowering, menopausal syndrome and other common middle -aged and elderly diseases such as constipation and insomnia, and it is also experienced in adjusting the sub -health of young people.

Chen Xia

Indications, doctor of medicine

Explorest time: Wednesday and Thursday morning

Main member of the famous Chinese medicine studio in Pudong New Area. He has rich clinical experience in the combination of traditional Chinese and western medicine.

Good at: Chinese and Western medicine combined treatment of various primary nephropathy and uric acid nephropathy, diabetic nephropathy, hypertension nephropathy, lupus nephropathy, starchy nephropathy, starch -like kidney disease, etc. Essence Common chronic diseases such as Chinese medicine comprehensive therapy to treat cardiovascular and cerebrovascular diseases, siege syndrome, functional gastrointestinal dysfunction, insomnia, etc., are also experienced in the adjustment of sub -health.

Lena

Tangzhen Community Health Service Center Traditional Chinese Medicine attending physician and attending physician of general department of Chinese medicine

Outpatient time for special diseases: Tuesday and Friday morning (Tangzhen Community)

Pudong New Area Famous Traditional Chinese Medicine Studio. It has a relatively solid basic theoretical knowledge of traditional Chinese and western medicine, and can better grasp the idea of ​​diagnosis and treatment of general diseases of traditional Chinese medicine. Reading classics, and can be more proficient in the classic Chinese medicine classic theoretical syndrome differentiation to treat common diseases such as diabetes and diabetic kidney diseases, hyperuricemia, gout and other communities.

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