Cases of diabetic nephropathy

Cases of diabetic nephropathy

Case summary: patient: Wang x Gender: female age: 46

Before admission situation: more than a decade ago, due to drink more, eat more, weight decreased significantly and went to the local hospital for diabetes, but found no other abnormal symptoms. Since then, she has been oral hypoglycemic, metformin and other drugs to control blood sugar. Because the patient does not have a good diet, so poor glycemic control. A year ago, began to appear swollen eyelids, nocturia increased. About half a year ago, Wang appeared and facial edema of lower limbs, urine routine examination; urine protein (+ ~ + +) accompanied by a poor diet, poor complexion, dizziness and other symptoms.

Physical examination: 5.6mmol/L fasting blood glucose, 2 hour postprandial blood glucose 15.1mmol/L, urine red blood cells in 3.7 * 10*12/L, urine protein (+ +), (+), blood hemoglobin 107g/L 123.5umol/l, serum creatinine, urea nitrogen 7.2mmol/L creatinine clearance rate 63ml/mim. GFR examination of nuclear medicine; 50ml/min. Experts believe that although the renal function of patients with no more than the normal range, but according to the endogenous creatinine clearance rate and the decrease of the GFR inspection results can be found that Zhang is a chronic renal insufficiency decompensation, should be diagnosed as type 2 diabetes with nephropathy. Although the patient's renal function has not yet appeared obvious obstacles, but GFR examination; 50ml/min, indicating that 50% of patients have been damaged by the renal unit, this is the best time to treat. Otherwise, the condition will develop toward the direction of uremia of chronic renal failure, the consequences be unbearable to contemplate!

Diagnosis: diabetic nephropathy renal insufficiency compensatory period.

Treatment: taking into account the poor function of the islets of Langerhans, the formation of the expert Wang continued to use short acting insulin to control postprandial blood glucose. Focus on the use of Guiyuan KanXian Yishen therapy, and with characteristics of Yishen Kangxianling series of traditional Chinese medicine and nourishing Yin, clearing heat, promoting blood circulation and removing blood stasis can reduce the side effects of glucocorticoid, cytotoxic drugs on liver damage and bone marrow suppression can also be used to protect traditional Chinese medicine, and give full play to the role of Tonifying the kidney and anti fibrosis effect of Kangxianling series of traditional Chinese medicine. Wang did not expect that, just 17 days after hospitalization, facial and lower extremity edema completely subsided. Continue to treat a month later, 5.1mmol/L fasting blood glucose, 2 hour postprandial blood glucose 8.2.mmol/L, urine red blood cells in 4.8 * 10*12/L, urinary protein (-), BLD (-), hemoglobin 123g/L 83.2umol/l, serum creatinine, urea nitrogen 5.2mmol/L creatinine clearance rate 72ml/mim. GFR examination of nuclear medicine; 72ml/min. Experts consider a better control of blood glucose, kidney function has been significantly restored, you can take medicine home consolidation treatment.

 

pre:Treatment turn out of the hospital, and then review is negat
next:Children with acute glomerulonephritis

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