Diabetic Nephropathy

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Usually, when a patient is diagnosed with diabetes, the physician orders a complete urinalysis to check for glucose and ketones, but the focus of diagnostic testing is early detection of microalbuminuria. Albumin, one of the most important blood proteins, starts to leak into the urine early in diabetic nephropathy, causing microalbuminuria. If albumin is detected in a routine urinalysis, your patient will need to provide a 24-hour urine sample. Normally, a person excretes 30 mg of albumin in 24 hours. The physician will diagnose microalbuminuria-and diabetic nephropathyif your patient excretes albumin at a rate of 31 to 299 mg/day or 20 to 199 /minute, measured on three different occasions over 6 months.

If your diabetic patient has a normal urine albumin excretion level, then urine albumin and renal function tests should be performed annually. Keep in mind that a urine dipstick test for protein can't detect mild to moderate increases in albumin.

Serum creatinine and blood urea nitrogen (BUN) levels may be used as indirect measurements of the GFR. Normally, the GFR ranges from 100 to 125 ml/minute. Serum creatinine and BUN levels increase as kidney function deteriorates. A doubling of the creatinine level may reflect a 50% reduction in the GFR.

However, these tests aren't always reliable at detecting early nephropathy, and they're not reliable in patients with diminished muscle mass, such as elderly or malnourished individuals, or in those who have protein restrictions, such as patients with advanced renal disease. Also, BUN levels vary based on your patient's hydration or the presence of other disorders, such as liver disease.

Creatinine clearance also measures the GFR. If your patient has diabetic nephropathy, creatinine clearance will be decreased because her glomeruli can't adequately filter the blood.

Article Source: http://depositarticles.com/

Article Written By Robert Baird, author for www.curingdiabetes.org/. Find oral antidiabetic drugs for the treatment of Type 2 diabetes and various test to diagnose diabetes.

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