Diabetic nephropathy is a common complication of diabetes mellitus, one of the manifestations of diabetic systemic microangiopathy, clinically characterized by proteinuria, progressive renal impairment, hypertension, edema, and severe renal failure in the late stage, and is one of the main causes of death in diabetic patients. With the prolongation of life expectancy of our population, the change of living habits and diet structure, the prevalence of diabetes is on the rise and diabetic nephropathy is also on the increase, early protection of the kidneys must do the following seven steps. Control blood sugar up to the standard Since diabetes is found, it must be treated, and the treatment must be up to the standard. Because the early symptoms of type 2 diabetes are not obvious, such as the emergence of symptoms and then seek medical attention, the patient has more or less complications, which is not conducive to patient treatment and prognosis. Therefore, we advocate control to achieve the standard, not to achieve the standard is equal to no treatment. Professor Yang Wenying, director of the Chinese Medical Association’s Division of Diabetes, recently pointed out that strict blood glucose control is the key to reducing the risk of diabetes and its complications, and that it is a very serious fact that less than 30% of Chinese patients with type 2 diabetes have achieved the standard rate of blood glucose control. Unstable or high blood glucose levels can cause chronic damage to the heart, brain, kidneys, eyes and other important organs of the body, prompting complications, especially causing irreversible damage to the kidneys, and we must pay attention to treatment. Second, control blood pressure to normal level diabetic patients are mostly accompanied by hypertension, which doubly aggravates the kidney burden. Therefore, patients with diabetic nephropathy should also pay attention to the control of blood pressure. Lowering blood sugar and reducing glomerular pressure is the main way to protect the glomerular membrane, and for those with hypertension we we must lower the pressure to below 140/90mmHg. Medical doctors have conducted long-term observation and research to confirm that the incidence of cardiovascular disease is lowest when the blood pressure is controlled below 140/90mmHg. In patients with hypertension who have diabetes, blood pressure should be controlled even lower, and blood pressure should be <130/85 mmHg. In patients with hypertensive renal impairment, blood pressure should be controlled at 125-130/75-80
mmHg or less to slow down the development of renal impairment. Although hypertension is not a factor in the development of diabetic nephropathy, hypertension can accelerate the progression and deterioration of diabetic nephropathy. Anti-hypertensive treatment can reduce urinary protein and delay the decline of glomerular filtration rate (GFR) in the early stage of diabetic nephropathy. Third, reduce sodium intake type 2 diabetic patients are mostly accompanied by overweight, obesity, large food intake, heavy taste, more salt intake. Sodium is mainly excreted through the kidneys, with about 80% reabsorption. High sodium intake can contribute to pathological changes in the kidney blood vessels, increasing the burden on the kidneys and affecting kidney function. Experts have found that high salt intake can accelerate the decline of kidney function in kidney patients. Therefore, patients with kidney disease must control the intake of sodium. In addition, people who consume too much sodium are prone to hypertension, and hypertension can also increase the burden on the kidneys. Fourth, early interventional treatment of diabetic patients early interventional treatment effect is obvious, some scholars apply antioxidants such as vitamin E and vitamin C, vascular converting enzyme inhibitors, traditional Chinese medicine Liu Wei Di Huang Wan and other interventional treatment for diabetic patients without diabetic nephropathy and those who have already developed diabetic nephropathy, have achieved good results, blood pressure is not at the ideal level can also be combined with antihypertensive drugs. This increases the sensitivity of insulin on the one hand, and reduces the filtration of urinary protein in patients with existing proteinuria on the other hand, playing a role in protecting the kidneys. Of course, in the process of treating diabetes, attention should also be paid to minimizing the damaging effects of hypoglycemic drugs on the kidneys, and the early application of insulin can also protect the kidneys. V. Regular monitoring of blood glucose levels changes with the person’s sensitivity to environmental seasonal changes and also fluctuates with the application of drugs, regular monitoring of blood glucose, regular monitoring of urine protein and blood pressure levels are necessary. Some patients pay attention to it in the early stage of treatment and start to be paralyzed over time, thinking that the medication control is normal, not to monitor it, unaware of it, and then to solve the problem when high blood sugar causes kidney problems, they may miss a good time to prevent complications. Some patients only test fasting blood sugar without monitoring postprandial blood sugar, ignoring the monitoring of postprandial hyperglycemic state. Also missed some of the early diabetic patients with postprandial hyperglycemia as the main manifestation, once found to have diabetes is already a kidney lesion. Sixth, a reasonable diet clinical experimental research shows that a high protein diet can increase the blood flow and pressure of the glomerulus and aggravate the renal hemodynamic changes caused by hyperglycemia. Diet for clinical stage diabetic nephropathy can slow down the rate of decline of its glomerular filtration rate. The amount of protein required for patients without the appearance of urinary protein is 0.8 grams per kilogram of body weight a day, and for patients with the appearance of urinary protein 0.6 to 0.8 grams per kilogram of body weight a day, which should be based on high-quality animal protein. Under the guarantee of insulin, the amount of carbohydrates can be increased to ensure that there are enough calories to avoid the increase of protein and fat decomposition, which will increase the burden of renal excretion. In addition, reduce the intake of various high-calorie fried foods and crude protein, which is beneficial to the protection of the kidneys. Seven, avoid the use of nephrotoxic drugs to avoid the use of drugs harmful to the kidneys: such as gentamicin, streptomycin, butylamine kanamycin and some Chinese medicine preparations.