Diabetes and uremia these two disease seemingly unrelated but are closely linked. The kidney damage caused by diabetes, diabetic nephropathy, is one of the most common complications of diabetes. The incidence of DN in diabetic patients is about 34.7, second only to cardiovascular and cerebrovascular diseases. So why does diabetes become diabetic nephropathy and further uremia?
Genetic background. It has long been recognized that the occurrence of DNs has a genetic background. There are differences in the incidence and severity of DN patients from different ethnic groups, And in the same race, the disease also has a certain family aggregation. In clinical practice, we often find that some patients with better long-term control of blood sugar will still develop diabetic nephropathy, while some patients with diabetes do not have ideal control of blood sugar. But does not have diabetic nephropathy, this and patient's heredity factor has very much relation.
Hyperglycemia. As early as 1985, a study by the WHO Diabetes Research Group confirmed that DNs were mainly found in patients with fasting blood glucose greater than 7.8 mmol / L. Hyperglycemia is a characteristic manifestation of diabetes. A series of metabolic disorders caused by hyperglycemia are important factors in the development of DN and eventually develop into uremia. The biochemical structure and physical and chemical crosslinking properties of these proteins were changed, resulting in proteinuria. Enhanced blood glucose control delayed the development of microalbuminuria in patients with type 1 and type 2 diabetes. And delay the progress of microalbuminuria to clinical proteinuria.
Hypertension. Hypertension is an important factor in the development of DN. Hypertension can accelerate the development of DN and renal function decline, and even develop uremia. Most hypertension is secondary to diabetes. In type 2 diabetes, hypertension often occurs before diabetes. But in any case, high blood pressure can in turn worsen diabetes. Controlling blood pressure is very important, especially in patients with type 1 diabetes. Controlling blood pressure early in DN can delay the development of uremia by about 10-20 years.
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