Patient Question:Disease:Hypertension Diabetes Nephropathy Description:Hypertension for 10 years, diabetes for 5 years. He had insulin for one month at the beginning of his diabetes, and his blood glucose was normal (about 3 years), but in the fourth year his blood glucose rose again (about 7.0-9.0). He started to take Chinese medicine for a month, but did not see any effect, so he stopped taking Chinese medicine and went to the hospital. The doctor recommended hospitalization, and in October 14, he was hospitalized for 28 days and checked the 24-hour urine protein quantification twice at 63 and 135, respectively, and confirmed the diagnosis of diabetic nephropathy. The longest one is Lowe’s, and now I’ve been taking it for 3 months (I’ve had a cold for the last two days, and I’ve always had a headache). Captopril was eaten, but the dry cough was very strong. Beijing Union Medical College Hospital Department of Traditional Chinese Medicine Yin Dehai Previous treatment and effects: 1. 5 years ago (Tianjin Diabetes Hospital) found diabetes, playing insulin for 1 month. Then stopped taking it. Blood sugar and blood pressure were normal. 2.2 years ago (Tianjin Diabetes Hospital) blood sugar and blood pressure increased, prescribed metformin and glargine, eat more than a year. Unstable control. Took Chinese medicine for 1 month, no effect. The blood glucose and blood pressure are elevated, and the blood pressure is between 135/90 and 120/75. I would like help:My blood sugar and blood pressure are under control, why is the kidney damage not only not improved but also worsened? How to treat this diabetic nephropathy? Is it necessary to use hormonal drugs? I was told to take Chinese medicine together with herbal medicine, is it possible to take only Chinese medicine? Is it possible to reverse this disease? Reply: “The 24-hour urine protein quantification was 63 and 135 respectively” I don’t understand what you mean by this statement. There are two different methods for measuring urine protein, one is the 24-hour urine protein quantification you mentioned. Generally speaking, when a positive urine protein (with a “plus” sign) is found in a routine urine examination, in order to clarify how much urine protein is excreted, it is necessary to keep urine for 24 hours and use the chemical reaction turbidimetric method to determine the urine protein concentration, and then multiply the measured concentration by the 24-hour urine protein quantification. The concentration measured is multiplied by the 24-hour urine volume to obtain the total amount of urine protein excreted in 24 hours, which is generally measured in grams. The amount of urine protein generally indicates the severity of kidney disease. Another type of urine protein test is called microalbuminuria test, which is used to detect the albumin content in urine through the principle of specific albumin antigen antibody reaction, and can detect micrograms of albumin, so when the routine urine test is negative for urine protein (undetectable), this method can be used to detect whether there is microalbumin in urine in order to assess early kidney damage very early. There are 3 methods of detection, one is to retain urine for 24 hours, test the urine albumin concentration and multiply it by the 24-hour urine volume to obtain the total amount of albumin eliminated in 24 hours, the normal value is less than 30 mg, between 30-300 mg is called microalbuminuria, suggesting early kidney damage, greater than 300 mg is a large amount of protein urine, the urine must be positive in the routine urinalysis, generally this situation of The patient does not need to do the measurement of microalbumin, just do the ordinary 24-hour urine protein quantification can be it. The second is to keep the urine at night for a period of time (4 hours or 8 hours of urine), determine the concentration of urine albumin and then convert the urine albumin excretion rate per minute according to the volume of urine for this period of time and divide it by the time, so the test report is **ug/min (**micrograms/minute), the normal value is less than 20ug/min, if 20-200ug/min is called microalbuminuria. Proteinuria, more than 200ug/min is a large amount of protein urine, the third is to take a single urine at the same time to test the urine albumin concentration and urine creatinine concentration, urine creatinine concentration as a correction value to avoid the difference in urine concentration (drink more urine dilution, drink less urine concentration) and the measured albumin concentration, the general hospital report unit is **mg/gCr (how many milligrams of albumin per gram of creatinine), the normal value is less than 30mg/gCr. The normal value is less than 30mg/gCr, 30-300mg/gCr for microalbuminuria, and more than 300mg/gCr for massive proteinuria. Patients because they are not professionals, reported test indicators are not clear, it is difficult for doctors to determine your condition, and for a kidney disease patient the quantitative data of urine protein is often the key to determine the severity of the disease and decide how to treat next. You can come to my clinic if you have the condition.