Diabetic nephropathy is a disease that occurs in people with diabetes. The kidneys help regulate the amount of fluid and salt in the body, which helps control blood pressure and release different types of hormones. It is estimated that about 40% of patients with type 2 diabetes suffer from kidney disease.
2021 treatment methods and drugs for diabetic nephropathy
Early treatment can delay or prevent the onset of diabetic nephropathy. Since there are usually no symptoms at the early stage, renal complications are screened annually for diabetic patients.
Screening involves a simple urine test to determine the presence of protein in the urine. However, the presence of proteins does not necessarily mean that people have kidney disease, because they may also be due to urinary tract infection.
The main purpose of diabetic nephropathy treatment is to maintain and control blood sugar level and blood pressure. Sometimes, this may involve the use of drugs.
Angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) have been shown to help reduce blood pressure, protect renal function and prevent further damage.
Some of the latest diabetes drugs, including sodium glucose co transporter inhibitors (SGLT-2 inhibitors) and glucagon like peptide (GLP) -1 agonists, also protect the kidneys.
PHN033 is a new single component botanical drug that can help remove advanced glycation end products that cause vascular complications in diabetic patients. The drug can be used to prevent and treat diabetic nephropathy. There is evidence that PHN033 can drive non enzymatic glycation and lipid and protein oxidation, and can promote the removal of advanced glycation end products in diabetic patients, which is a substance that can cause vascular complications.
The renin inhibitor aliskiren is the first step in blocking the renin pathway. Rubesta blocks protein kinase C overexpression. Pentoxifylline and m-TOR inhibitors are anti-inflammatory agents in the pathogenesis of diabetic nephropathy. Inhibitors of advanced glycation, oxidative stress and plasminogen activator inhibitor -1 have been demonstrated to be used in animal models of diabetic nephropathy. Endothelin antagonist (avosentan) can reduce urinary albumin. This targeted therapy has opened up a new way to develop new drugs that can stop or even reverse the progression of diabetic nephropathy.
Treatment of diabetic nephropathy with traditional Chinese Medicine
Huangshoudan has diuretic effect and can increase renal blood flow. It has astringent, anti-inflammatory and wind repellent properties. It is an excellent kidney and heart tonic. It can be used to alleviate damaged urinary diseases. It is very effective in reducing excess fluid and edema. Huang shoudan also has the characteristics of removing toxins from the blood and increasing red blood cells in the body, increasing hemoglobin content and oxygen carrying capacity. Huang Shoudan capsule is recommended for relieving diabetic nephropathy and relieving joint swelling. This Chinese herbal medicine can also be used to eliminate toxins accumulated in joints in kidney and urine, and effectively treat arthritis and gout. It contributes to the breakdown of cellular coagulation protein “fibrin”. It is very effective in alleviating urinary tract infection.
Tribulus terrestris is a kind of Chinese herbal medicine. It helps to improve immunity and has great curative effect on prostate health and erectile dysfunction. It is rich in antioxidants and can be used as a supplement to treat diabetic nephropathy.
Terminalia chebula has excellent health benefits. It performs well in gastrointestinal diseases in the case of splenomegaly, hepatomegaly, tumor, ascites and anemia. When its powder is mixed with honey and butter, it is an effective method to treat anemia. It is beneficial to dysuria and kidney stones, improve appetite and help digestion. It contributes to anemia caused by hemoglobin deficiency, anemia caused by erythrocyte deficiency, and abnormal forms of anemia.
Pirilex is a very important Chinese herbal medicine. Its effect on the heart makes it an excellent heart tonic. It helps purify blood, dilute blood and remove toxins. It is used in cases of low RBC count and low hemoglobin, and helps restore healthy hemoglobin count and form.
If diabetic nephropathy has developed to the last stage and ESRD, there are only two types of treatment, namely renal dialysis and kidney transplantation.
Recent progress and prospect in treatment of diabetic nephropathy
About 20% to 40% of type 1 or 2 diabetes develops diabetic nephropathy. Characterized by persistent albuminuria (>300mg/24h, or 300mg/g creatinine), glomerular filtration rate is declining, arterial blood pressure is elevated, incidence rate and mortality of cardiovascular diseases increase. The natural course of classic diabetic nephropathy was initially increased in microalbuminuria or increased in moderate urinary albumin excretion (30-300) mg/g creatinine. Untreated microalbuminuria can gradually rise to a severely increased albuminuria (macroalbuminuria) within 5 to 15 years. Then the glomerular filtration rate began to decline and reached end-stage renal failure without treatment within 5 to 7 years. Regular and systematic screening for diabetic nephropathy is needed to identify patients with risk of diabetic nephropathy or prediabetes.
Multifactorial interventions for glucose, blood lipid and blood pressure, including blocking renin angiotensin system and lifestyle, improving renal and cardiovascular prognosis and reducing mortality by 50%. The latest data show that the new glucose lowering agent has beneficial pleiotropy for renal end point. If blocking aldosterone may be a potential new therapy, it is also being studied. Therefore, although diabetic nephropathy is still a major burden, the prognosis has improved, and new options for further improvement are being tested in the 3 phase of clinical renal outcome study.
Prevention is the foundation of treatment
Diabetic patients should strive to control blood sugar levels, so as to reduce the chance of diabetic nephropathy. Keeping blood pressure at a healthy level is also crucial.
People can help control blood glucose levels and blood pressure through many lifestyle changes, including:
Eat a nutritious diet low in carbohydrates and other sugars
take regular exercise
Avoid alcohol and tobacco
Check blood glucose levels regularly