I stage when diagnosing T1DM, the GFR and thickness have increased. The
increases of glomerular and kidneys is the typical manifesto. Patients have
transient microalbuminuria, after using insulin, it will disappear. The high GFR
can lower after treatment, but cannot return to normal. If T1DM occurs before
adolescence, this stage will last for a long time.
Ⅱstage, in this stage, kidneys damage has occurred, but no clinical symptoms.
This stage appears after 2 years for DM onset. Some patients will last for many
years in this stage, even for life time. The thickness of Glomerular basement
membrane often increases, and mesangial area will proliferate. When the DM is
not controlled well and taking exercise, patients will occur to
microalbuminuria, but it’s reversible. The GFR still increase, and pressure is
normal.
Ⅲ Stage. This stage is the high-risk period of DN. The typical patients are
after 10-15 years’ Diabetic Mellitus. Microalbuminuria continuously increases
and GFR still increase. Blood pressure begins to rise. It’s indicated in the
longitudinal study that anti-hypertensive treatment can obviously improve
microalbuminuria. Using insulin pump or intensive treatment in this stage can be
conducted after blood sugar being improved obviously; the output of urinary
albumin reduces or remains unchanged. Learn About: Why do I Sweat a Lot with Stage 4 Kidney Failure
Ⅳ stage. Patients entering this stage often have 15-25 years’courses. About
40% patients with T1DM will develop into this stage. There will be typical
changes in pathology. The diagnosis is mainly relied on clinical manifestos. The
output of urinary protein will increase (more than 0.5/ 24h). Most patients will
have high blood pressure. The GFR begins to drop. The effective
anti-hypertensive treatments can slower the rate of GFR dropping.
Ⅴ stage. This stage is terminal kidney failure. The characteristic is the
glomerular capillary blockage, accompanied glomerular hyaline variety. The GFR
has been enough low; with nitrogen retention and obvious hypertension.
Not all patients with T1DM will pass the above five stages. Most of patients
will stop at the second stage, after 20-30 years, they still have no obvious
kidney damage. But if patients develop into the third stage (Microalbuminuria
stage), it’s possible to develop into the fourth stage, appearing typical DN.
For the treatment, it should attempt to make the disease stop at the third
stage. Once developing into fourth stage, the disease will be irreversible, and
most patients will enter into the terminal Renal Failure.If you fail to find the info you want, you can email to kidneyask@hotmail.com for a reply.
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