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The main goal of the treatment of premarin pills is to prevent and delay as much as possible the further progression of the disease to CRF, to reduce the risk of developing cardiovascular complications (CHD, myocardial infarction, stroke). Common in the treatment of different stages of diabetic nephropathy is strict control of blood sugar, blood pressure, compensation for violations of mineral, carbohydrate, protein and lipid metabolism.

Angiotensin-converting enzyme (ACE) inhibitors are the drugs of first choice in the treatment of diabetic nephropathy. enalapril, ramipril, trandolapril and angiotensin receptor antagonists (ARA). irbesartan, valsartan, losartan, normalizing systemic and intraglomerular hypertension and slowing down the progression of the disease. Drugs are prescribed even with normal blood pressure in doses that do not lead to the development of hypotension.

Starting from the stage of microalbuminuria, a low-protein, salt-free diet is indicated. limiting the intake of animal protein, potassium, phosphorus and salt. To reduce the risk of developing cardiovascular diseases, correction of dyslipidemia is necessary due to a low-fat diet and taking drugs that normalize the blood lipid spectrum (L-arginine, folic acid, statins).

At the terminal stage of diabetic nephropathy, detoxification therapy, correction of the treatment of diabetes mellitus, intake of sorbents, antiazotemic agents, normalization of hemoglobin levels, and prevention of osteodystrophy are required. When cuttingWhen kidney function deteriorates, the patient is asked to buy premarin online hemodialysis, permanent peritoneal dialysis, or surgical treatment with a donor kidney transplantation method.

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At the terminal stage of diabetic nephropathy, there is a sharp decrease in the filtration and concentration functions of premarin pills. massive proteinuria, low GFR, a significant increase in the level of urea and creatinine in the blood, the development of anemia, pronounced edema. At this stage, hyperglycemia, glucosuria, urinary excretion of endogenous insulin, as well as the need for exogenous insulin can significantly decrease. Nephrotic syndrome progresses, blood pressure reaches high values, dyspeptic syndrome develops, uremia and chronic renal failure with signs of self-poisoning of the body by metabolic products and damage to various organs and systems.

Diagnosis of diabetic nephropathy. Early diagnosis of diabetic nephropathy is a major challenge. In order to establish the diagnosis of diabetic nephropathy, a biochemical and general blood test, a biochemical and general urinalysis, a Reberg test, a Zimnitsky test, and an ultrasound scan of the kidney vessels are performed.

The main markers of the early stages of diabetic nephropathy are microalbuminuria and glomerular filtration rate. In the annual screening of patients with diabetes mellitus, the daily excretion of albumin in the urine or the ratio of albumin / creatinine in the morning portion is examined. The transition of diabetic nephropathy to the stage of proteinuria is determined by the presence of protein in the general analysis of urine or urinary albumin excretion above 300 mg / day.

There is an increase in blood pressure, signs of nephrotic syndrome. Late stage diabetic nephropathy is not difficult to diagnose. to massive proteinuria and a decrease in GFR (less than 30 - 15 ml / min), an increase in the levels of creatinine and urea in the blood (azotemia), anemia, acidosis, hypocalcemia, hyperphosphatemia, hyperlipidemia, swelling of the face and the whole body is added.

It is important to differentiate diabetic nephropathy from other kidney diseases. chronic pyelonephritis, tuberculosis, acute and chronic glomerulonephritis. For this purpose, bacteriological examination of urine for microflora, ultrasound of the kidneys, excretory urography can be performed. In some cases (with early-developing and rapidly increasing proteinuria, sudden development of nephrotic syndrome, persistent hematuria), a fine-needle aspiration biopsy of the kidney is performed to clarify the diagnosis.