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In the urine, proteinuria (protein in the urine), hematuria (blood in the urine), cylindruria are detected. Anemia becomes pronounced. Arterial hypertension is persistent, and the pressure reaches high numbers. At this stage, despite the high numbers of blood glucose, sugar in the urine is not detected. Surprisingly, at the nephrosclerotic stage of monograph nephropathy, the rate of degradation of endogenous insulin decreases, and the excretion of insulin in the urine also stops. As a result, the need for exogenous insulin is reduced. Blood glucose levels may drop. This stage ends with chronic renal failure.
Ideally, diabetic nephropathy should be detected early. Early diagnosis is based on monitoring the level of microalbumin in the urine. Normally, the content of microalbumin in the urine should not exceed 30 mg / day. Exceeding this threshold indicates the initial stage of the pathological process. If microalbuminuria becomes permanent, this indicates a relatively rapid development of severe DN.
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Another early marker of diabetic nephropathy is the determination of renal filtration. For this purpose, the Reberg test is used, which is based on the determination of creatinine in daily urine. In the later stages, diagnosis is not difficult and is based on the identification of the following changes. Proteinuria (protein in the urine). Decreased glomerular filtration rate. An increase in the levels of creatinine and urea in the blood (azotemia). Arterial hypertension. When diagnosing diabetic nephropathy, it is very important to buy monograph online a differential diagnosis with other diseases that can lead to similar changes in the analyzes.
Chronic pyelonephritis. Distinctive features are the presence of a characteristic clinical picture, leukocyturia, bacteriuria, a characteristic picture on ultrasound and excretory urography. Tuberculosis of the kidneys. Distinctive features. lack of flora growth in the presence of leukocyturia, detection of mycobacterium tuberculosis in the urine, a characteristic picture with excretory urography. Acute and chronic glomerulonephritis. In some cases, a kidney biopsy is performed to clarify the diagnosis. Here are some indications for a diagnostic kidney biopsy.
The development of proteinuria earlier than 5 years after the development of type I diabetes. Rapid increase in proteinuria or sudden development of nephrotic syndrome. Persistent micro- or macrohematuria. The absence of damage to order etodolac online organs and systems characteristic of diabetes mellitus.