When diabetes patient appear proteinuria, can not accordance with the thinking about is caused by diabetes, in fact, proteinuria in diabetic patients, often with primary glomerular disease, or other secondary glomerular diseases, diabetes mellitus is another kind of kidney disease, and renal damage in diabetes is not. Here are some clinical clues for diabetes mellitus combined with non-diabetic kidney injury:
Type 2 diabetes patients with non diabetic kidney damage, most of the course of diabetes is short, most in less than 5 years, from kidney disease onset time is short, some patients with diabetes at the same time or early onset of diabetes, the two lesions do not have time correlation.
The prevalence and degree of blood pressure in patients with type 2 diabetes mellitus and non-diabetic renal impairment are lower than those of diabetic patients, especially in patients with massive proteinuria or renal insufficiency.
Diabetic nephropathy hematuria is often not obvious, if patients with diabetes in addition to proteinuria, there are obvious glomerular hematuria, to consider whether combined with non diabetic kidney damage.
Proteinuria (nephrotic syndrome) lasts for more than 2 years without renal impairment.
Diabetic nephropathy is microvascular damage, consistent with the progress of retinal microvascular injury, when diabetic nephropathy occurs a large number of proteinuria, often also appear fundus retinopathy, if there is no retinopathy, then. It is possible to merge non diabetic kidney damage.
For these cases, renal biopsy should be considered in order to make a definite diagnosis.
Clinically, the main types of renal pathological diagnosis of diabetic patients with primary glomerular disease, IgA nephropathy, membranous nephropathy, mesangial proliferative nephritis, focal segmental glomerulosclerosis, also have amyloidosis kidney damage, multiple myeloma kidney injury and other secondary renal damage.
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