How should we Prevent and Treat Diabetic Nephropathy

Diabetic nephropathy also known as Kimmelstiel-Wilson syndrome, or nodular diabetic glomerulosclerosis and intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy ofcapillaries in the kidney glomeruli. It is characterized by nephrotic syndrome and diffuse glomerulosclerosis. It is due to longstanding diabetes mellitus, and is a prime indication for dialysis in many Western countries.
Therefore, how to prevent and treat Diabetic Nephropathy is of significant importance for patients withDiabetes. In order to prevent or prolong the progression of Diabetic Nephropathy, what should we do?
The key point of preventing Diabetic Nephropathy is receiving effective treatment as early as possible so as to make the blood sugar level under control. Once Diabetic Nephropathy occurs, the therapeutic schedule should be made according to the patients' condition in different stages.
In stage 1 Diabetic Nephropathy
In this stage, the key point of the treatment should target at controlling the blood sugar. If the blood sugar can be controlled well, the kidney lesion mainly shows the increase of the glomerular filtration rate, which can be reduced to normal level.
In stage 2~3 Diabetic Nephropathy
In these two stages, apart from controlling the blood sugar continuously, the patients should also adopt angiotensin-converting enzyme inhibitor(ACEI) or angiotensin receptor blockers(ARB) timely, no matter whether they have Hypertension. If they do have Hypertension, they should also adopt other antihypertensive drugs at the same time so as to lower the blood pressure.
Stage 1~3 is the best time for treating Diabetic Nephropathy, for in the three stages, the kidney damages can be reversed.
In stage 4~5 Diabetic Nephropathy
In these two stages, besides treating Diabetes, the treatment can only target at the symptoms, including lowering the blood pressure, promoting the urination, removing the edema and regulating the blood lipid. Once End-Stage Renal Failure occurs, renal replacement therapy such as dialysis, kidney transplant, or Stem Cell Transplant should be adopted.