Diabetic nephropathy is mainly manifested by different degrees of proteinuria and progressive decompensation of renal function. Since the onset of type 1 diabetes mellitus is clearer, and there are fewer complications such as hypertension and atherosclerosis compared with type 2 diabetes mellitus, it is currently staged according to the clinical course of type 1 diabetes mellitus.
Stage I: There is no clinical manifestation of nephropathy, only hemodynamic changes, when the glomerular filtration rate increases, kidney volume increases, and glomeruli and tubules hypertrophy. There may be transient microalbuminuria during exercise, emergency, and poor glycemic control.
Stage II: Persistent microalbuminuria with normal or elevated glomerular filtration rate and no clinical symptoms. Renal pathology of glomerular/tubular basement membrane thickening and widening of the tethered zone.
Stage III: Significant increase in proteinuria/albuminuria (urinary albumin excretion rate >200mg/24h, proteinuria >0.5g/24h), mild hypertension may be present, glomerular filtration rate decreases, but blood creatinine is normal. Renal pathology shows focal/diffuse sclerosis, K-W nodules, hyalinization of small arteries in/out of the glomerulus.
Stage IV: massive proteinuria, up to the level of nephrotic syndrome.
Stage V: Renal function continues to decline until end-stage renal disease.
Patients with diabetic nephropathy should go to the hospital in time and be treated under the guidance of professional physicians.