Five Stages of Diabetic Nephropathy
During the first stage, clinical manifestation is featured by enlarged kidney size (by 25%) and increased GFR (by 20%-40%). Kidneys are in the state of high blood perfusion, and normalization of blood sugar can block further kidney function decline or even reverse kidney function to normal standard.
When Diabetic Nephropathy develops into the second stage, there might be occurrence of microalbuminuria. Microscopic check can find evidence of slight and early stage glomerular pathological changes like membrane proliferation and so on. GFR can return to normal standard, and there is usually no hypertension.
While, the third stage of Diabetic Nephropathy indicates actual kidney function decline. Pathological check shows obvious glomerular membrane enlargement and incrassation. There could be already focal or segmental pathological changes in glomerular blood capillaries. Clinically, microalbuminuria become stubborn but urinalysis still shows negative in protein. Blood pressure increase begins and its occurrence is in accordance with the increase of microalbuminuria. Generally, when Diabetes develops into this stage, existing kidney damages are commonly irreversible.
When Diabetic Nephropathy develops into the fourth stage, daily protein urine can be more than 200ug, and it intends to be a continuous one. The occurrence of edema and low serum albumin can be possible, with nearly 30% of all patients experiencing massive protein urine, edema and hypertension, the so called three most typical symptoms of Diabetic Nephropathy. GFR decreases in an accelerated speed, with 1ml/min decrease commonly. Hypertension commonly occurs to all patients with this stage Diabetic Nephropathy, and nearly 30% of overall kidney glomeruli show evidence of sclerosis.
The fifth stage is renal failure stage, which can develop into Uremia within three to four years. Microscopic check may show large portion of sclerosis. Clinically, typical symptoms like Anemia, short of breath can be common.
As we can tell from the above mentioned contexts, Diabetic Nephropathy can be divided in to five stages. During the first three stages, damages in kidneys can be reversed, while with the development of kidney function decline, it becomes harder and harder to restore lost kidney function.
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