2016年12月31日星期六

How to treat diabetic

Diabetic nephropathy, what are the conventional treatment? What are the main symptoms and hazards of diabetic nephropathy? Early diagnosis of diabetic nephropathy in time for treatment
What is the treatment of diabetic nephropathy? Diabetic nephropathy is due to diabetes, long-term increased blood sugar caused by kidney damage, diabetes is the most common and most dangerous complications. The focus of the military diabetes treatment center experts said that the generalized diabetic nephropathy refers to the occurrence of diabetic patients with a variety of kidney disease, including infection, ischemia, etc., narrowly defined diabetic nephropathy due to high blood sugar caused by renal tuberous sclerosis Of the renal lesions. What is the comprehensive treatment of diabetic nephropathy?
1, early detection of diabetic nephropathy: early diabetic nephropathy can not see through the urine routine, so only 24-hour urine microalbumin on a regular basis to check, so that early detection of early diabetic nephropathy, early treatment of renal disease can be reversed. Both patients with type 1 diabetes and type 2 diabetes need to be examined at least once a year.
2, control of blood pressure: for type 1 diabetes patients, most of the hypertension are secondary to diabetic nephropathy, and type 2 diabetes, there are many high blood pressure and diabetes coexist. But in any case, hypertension, in turn, could further aggravate diabetic nephropathy. Therefore, control of blood pressure in diabetic nephropathy is very important. Especially for patients with type 1 diabetes, if early control of blood pressure in nephropathy may delay the development of advanced renal failure more than 10 to 20 years.
3, antihypertensive drug selection: Many types of drugs to control blood pressure, in which conversion enzyme inhibitors (ACEI) is often the best choice, because it can lower blood pressure, but also improve diabetic nephropathy.
4, protein intake limit: a diabetic nephropathy, reduce protein intake of food, can reduce the burden on the kidneys, delaying the development of nephropathy. The reduced protein portion of the food is usually supplemented by carbohydrates.
4, eating high-quality protein: limit protein intake, protein intake is not prohibited, because the protein is, after all, the human body needs the necessary nutrients. At this point moderate eating quality protein is the best choice. On the one hand, food intake is not large, no increase in the burden on the kidneys, on the other hand high-quality protein can meet the body's protein needs. High-quality protein include: fish, lean meat, eggs and so on.
5, control of blood lipids: like all other chronic complications of diabetes, blood lipids is always a factor, so in order to make good prevention and treatment of diabetic nephropathy, you need to lipid, whether triglycerides, or cholesterol, try to control the normal .
6, dialysis: when the development of renal disease to uremia stage, when renal failure, the kidneys can not be the body's metabolic toxic excreted, then serum creatinine and urea nitrogen were significantly increased, in this case, only by dialysis Of the method to maintain the body's normal toxic excretion. In other words, the use of dialysis to sustain life.
7, blood sugar control: diabetes is a gradual process of development, once the clinical manifestations, and diabetic nephropathy has been difficult to cure, so the first treatment of diabetes
Measures is to control blood sugar. Because most of the oral hypoglycemic drugs need to be excreted through the kidneys (sugar flat, except sugar level), so when the kidney damage serious, should avoid the use of these drugs.

Side Effect of Dialysis


(1)Dialysis disequilibrium syndrome:The incidence rate is 3.4%-20%.The side-effects of the hemodialysis are mainly the symptoms of sickness,vomiting,anxiety and so on.The worse patients may be convulsive,insensible and even die.The patient whose disease is not serious don’t need to take treatment.Those who are serious should take the treatment at once with high permeability solution,such as mannitol,50% glucose or 3% Sodium chloride of 10ml or be put in x-protein.Sometimes,they need to take the sedative and get the treatment according to the symptoms.And even worse one should stop the dialysis.
(2)Comprehensive syndrome:It is mainly caused by the use of new dialysis machine and pipeline,The treatment for it is mainly according to the different syndromes.
(3)Hypotension:It is one of the most common side effect of the dialysis,which incidence rate is 20%-40%.There are many reasons to cause the hypotension.It mainly happens in the middle and later stage of the dialysis. The hypotension of the later dialysis is mainly caused by the fast filtration and inadaptation of the acetate dialysate.Treatment:Lower one’s head and rise one’s feet,stop ultrafiltration,slower bypower flow,sniff oxygen.When it is necessary,add normal saline 100-200ml or 50%glucose 20ml.Also put in x-protein and give patient’s treatment according to the cause of the disease.
(4)To pyrogen reaction:Normally,don’t need to take medicine.When the patient feelhyperpyrexia,reduce the dialysis temperature,take a appropriate use of antihistamine,hormone and febrifuge.
(5)Heart failure:is one of the most dangerous and serious side effects.The treatment can be taken sequential dialysis or strengthen ultrafiltration accorfing to the symptoms.
(6)Arrhythmia:The incidence rate is about 50%.It is common in the ventricular premature beat.The reasons of the dialysis side effect are coronary heart disease, nonfunction,pericarditis,severe anemia electrolyte and acid-base disturbance,hyoxemia ,hypotension medicine and so on. Treatment:According to the reason and symptoms,give the equivalent treatment,but pay attention to the retention and toxicity effect of the patients.
(7)Muscle cramp: is one of the common side effect of the hemodialysis.The incidence rate is 10%-15%.It happens mainly in row of intestinal muscle foot,upper limband abdominal muscles.The reason is not sure for this symptom. Muscle cramp may be relevant to the histanoxia,lower sodium and the insufficiency of the circulating blood volume. Treatment: Slower or suspend ultrafiltration.Put in the normal saline 100-200ml or hypertonic sugar water and hypertonic saline.

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