Friday, September 6, 2013

Whether the Stem Cell Transplant is effective for the Diabetic Nephropathy

Clinic practice shows that the incidence of the Diabetic Nephropathy increases with the duration of Diabetic. The Diabetic disease in the early stage is showing that the kidney are being a high filtration because of its size enlarged, its glomerulus filtration increased, then gradual onset of interstitial proteinuria and microalbuminuria. With the extension of Diabetic disease course, protein urine, edema, hypertension and the decreased rate of glomerulus filtration would be occurred, then continuous the Renal Insufficiency and Uremia. These are the main causes of death of diabetes. The Diabetic patients have a high glucose in blood, while the glucose is like sediment in the river, when it is flowing through the kidney it can easily adhere to the strainer, make the kidney harder, narrower, obstructed and even destructed. All of these changes are in quietly process, therefore, the Diabetes is like “sugar-coated bomb” which is quietly entering into the kidney. The Diabetic Nephropathy patient should pay attention to the control of glycemic. If this disease treated well in early stage, it can be reversed. Or it cannot be reversed once it is in the stage of clinical albuminuria. Therefore, initial prevention is very important which also require the diabetic nephropathy pay attention to the control of glycemic. The Diabetic Nephropathy patients must pay attention to glycemic control. Hyperglycemia can promote the sodium reabsorption of kidney, which adds extracellular fluid volume, increases releasing of Atrial Natriuretic Factor (ANF). The ANF augments glomerular anterior vessels, constringes glomerular posterior vessels, which lead to form Renal Hypertransfusion and High Filtration; advanced Glycosylation end products can lead to increasing of glomerular basement membrane and mesangial matrix, and then damage the renal structure and function. However, urinary albumin is extremely relevant to the control quality of glycemic, and strict control of glycemic is the key point for preventing and reducing initial diabetic nephropathy. Excessive intake of protein, especially vegetable protein with bigger molecules can aggravate the damage of renal filtration and accelerate the glomerular capillary sclerosis. Although low protein is conducive to protect the kidney, and this diet is too early for the initial diabetic nephropathy therapy. Is stem cell transplant is effective for the diabetic nephropathy? The conventional therapy must be combined with the later treatment. With the development of medical science, stem cell transplant is applied to the therapy of diabetic nephropathy.

Treatment of Diabetic Nephropathy

The main diagnostic base of clinical diabetic nephropathy is proteinuria. If the factors, such as urinary infection, diabetic ketoacidosis, heart failure, glomerulonephritis, can be excluded, it’s more likely to be diabetic nephropathy. DN still has no effective therapy. The treatment principles are:1. To strictly control blood sugar to make the blood sugar close to the normal level, and prevent and delay the occurrence of DN; 2. to delay the rate of kidney function decrease;3.to treat with dialysis or kidney transplant. 1. To strictly control glucose. Before occurring to clinical DN, use insulin pump or multiple subcutaneous insulin injection to control Diabetic Mellitus and keep the glucose the normal level, which can delay even prevent the occurrence and development of DN. It is good for other complications to lower the increasing GFR and improve microalbuminuria. According to The Diabetes Control and Complications Trial(DCCT) study, T1DM treated with insulin intensive treatment can reduce by 35%-55% of the occurrence rate for DN. Controlling glucose for the patients having developed into clinical DN and having obvious proteinuria is less useful for disease development. Hypoglycemic drugs will change into insulin after occurring to Clincial DN. 2. To control hypertension. Hypertension can accelerate the development of Renal Failure. The effective hypotensive treatment can slower the speed of GFR reduction and decrease the output of urinary albumin. Angiotensin coverting enzyme inhibitor or angiotensin Ⅱ receptor antagonist can be the first choice, and often used together with other hypotensive drugs, such as calcium antagonists, diuresis, β adrenergic receptor, methyldopa, and clonidine. If patients’ pressure is more than ≥130//80mmHg 3. Limit in protein intake. Proper reducing protein intake in food can decrease the intraglomerular pressure, high filtration and proteinuria. In contrast, high protein food may aggravate glomerular histological lesion. Patient with renal insufficiency should strictly control protein intake and take high quality protein containing essential amino-acid. 4. Dialysis and kidney transplantation。 Once patients progress to renal failure, the only effective ways are dialysis and kidney transplantation. Kidney transplantation is the best treatment for diabetic nephropathy, prior to dialysis. But for the patients over age of 65, the after-transplantation effect is poor.

Tuesday, September 3, 2013

How to Prevent the Occurence of End-Stage Renal Failure (ESRF)

Patients with Polycystic Kidney Disease (PKD), Diabetes, hypertension, Nephrotic Syndrome, glomerular nephritis, frequent urinary tract infections (UTI), etc, are all susceptible for end-stage kidney disease. End-stage kidney failure patients may need to go dialysis or do kidney transplantation to sustain life. If we want to prevent the occurrence of end-stage renal failure, we need to be sure of some warning signs of kidney injuries: 1. Edema in eyelids, ankles, face, lower limbs, etc. Usually, protein loss in urine will go hand in hand with edema in kidney disease patients. Severe edema can result in short breath. 2. Frequent urinations at night, which is detectable if renal tubular reabsorption ability is damaged. 3. Foams or bubbles in urine which don′t disappear for a long time- this is a warning sign for protein loss caused by impaired glomerular filtration membrane. 4. Anemia. Anemia will happen as the kidneys can no longer produce enough erythropoietin- a hormone that promotes production of red blood cells. Patients will often feel very overfatigued. 5. Toxins such as creatinine and blood urea nitrogen levels increase gradually in blood, so the patient will have the following symptoms: Symptoms in digestive tract: poor appetite, vomiting and nausea; Poor sleeping quality Skin itching 6. Decreasing urine output. A main function of kidneys is to remove excess water from the body. With gradual loss of functioning kidney function, patients will find themselves making less and less urine. If you have some of the above symptoms, it is necessary to do full check-ups about your kidney condition. There are actually many inducing factors for kidney diseases. All in all, early detection, proper treatment and careful nursing measures protect you from entering end-stage kidney failure. Do you have any other questions? You can send an email to the experts in Funeng Kidney Disease Hospital,or you also can call the phone number directly. Our experts will reply you as soon as possible.