Diabetic nephropathy is one of the most serious chronic complications of diabetes. nearly 50% of patients with type 1 diabetes have chronic renal failure, while 5% to l0% of patients with type 2 diabetes also have renal failure. How do I know I have diabetic nephropathy? When diabetic patients have swollen eyelids or lower extremities after waking up, increased urine foam, increased nocturnal urination, etc., they should suspect whether they have diabetic nephropathy, because early diabetic nephropathy cannot be detected by urinary routine examination, so they can only have 24-hour urine microalbumin examination regularly to detect early diabetic nephropathy in time. Patients with type 1 diabetes with a disease duration ≥ 5 years, all patients with type 2 diabetes and all patients with hypertension should have their urine albumin rechecked regularly and annually. How to know the degree of diabetic nephropathy? Poor long-term blood sugar control will cause damage to the kidneys, nephropathy is gradually progressive, doctors in the clinical diabetic nephropathy is divided into five stages: 1, stage I: diabetes early kidney volume increased, glomerular filtration rate increased, without any symptoms. 2.Stage II: urinary routine protein negative, intermittent urinary microalbumin, intermittent mild increase in urinary albumin excretion rate, which can be reversed by active treatment. 3.Stage III: Early kidney disease. Urine routine egg positive, urine microalbumin continues to rise, urine albumin excretion rate 20-200, normal blood creatinine, urea nitrogen (i.e. normal renal function). 4. Stage IV: clinical nephropathy. Urinary albumin excretion rate >200, 24 h urinary albumin >300, decreased glomerular filtration rate, may be accompanied by edema and hypertension, positive urinary routine protein, significantly elevated blood creatinine and urea nitrogen (i.e. impaired renal function). 5. Stage V: end-stage renal disease. Systemic edema, hypertension and uremia, renal failure. Third, how to prevent and treat diabetic nephropathy? Diabetes is a gradual development process, once the clinical manifestations are clear, diabetic nephropathy is already difficult to cure, so the first treatment measure of diabetic nephropathy is to control blood sugar. Good glycemic control can reduce the incidence of diabetic nephropathy by half. When urine protein appears, improper choice of glucose-lowering drugs can lead to aggravation of nephropathy or damage to other organs, so consult a diabetic doctor to adjust glucose-lowering drugs. When a patient develops renal insufficiency, i.e., blood creatinine and urea nitrogen are significantly elevated, and receives insulin therapy, the daily insulin requirement will be significantly reduced due to reduced insulin excretion from the kidneys, and if the previous dose is continued, hypoglycemia is often likely to occur. In type l diabetic patients, most hypertension is secondary to diabetic nephropathy, whereas in type 2 diabetes, much hypertension is coexisting with diabetes. But in any case, hypertension can in turn significantly worsen diabetic nephropathy. Therefore, it is very important to control blood pressure in diabetic nephropathy, especially for type 1 diabetic patients, if blood pressure is controlled in the early stage of nephropathy, it is possible to delay the development of advanced renal failure to more than 10 to 20 years. There are many types of drugs to control blood pressure, each with its own indications recommended to find a professional doctor to adjust. When you have diabetic nephropathy, reducing the intake of protein foods (mainly meat, eggs and milk) can reduce the burden on the kidneys and slow down the development of nephropathy. Protein is an essential nutrient required by the human body. Eating high quality protein in moderation will not only not increase the burden on the kidneys, but also meet the protein needs of the human body. High-quality protein mainly includes fish, lean meat, eggs, etc. For diabetic nephropathy patients with different stages of protein intake, for patients with microalbuminuria protein intake should be controlled at 0.8-1.0g/kg of body weight per day (60 kg of body weight should be 48-60g of protein intake per day), for patients with massive proteinuria or renal insufficiency should be controlled at 0.6-0.8g/kg of body weight per day. What should not be neglected is blood lipids, whether triglycerides, cholesterol or LDL, which should be controlled as normal as possible. When kidney disease develops to the end stage, when renal failure occurs, the kidneys are unable to excrete the toxic substances metabolized by the body, and the blood creatinine and urea nitrogen are significantly elevated at this time. In this case, the only way to maintain the normal excretion of toxic substances from the body is through dialysis, in other words, to use dialysis to maintain life.