When serum creatinine level rises, Diabetic Nephropathy patients should also focus treatment on the control of blood sugar, blood pressure and blood cholesterol level and other cardiovascular risk factors. On the one hand, to delay the progression of kidney disease and avoid uremia. On the other hand, to prevent the occurrence of cardiovascular and cerebrovascular complications so as to reduce mortality.

Diabetes mellitus - Diabetic Nephropathy - chronic renal failure - uremia is a common outcome in many diabetic patients. If Diabetic Nephropathy patients show increased serum creatinine, it means renal function has been damaged and kidney disease has entered a serious stage.

Most patients believe that when blood creatinine is high, it is necessary to reduce creatinine. This is understandable, but often futile.

In general, chronically elevated creatinine cannot be lowered. The aim of active treatment, one is to delay the progression of kidney disease and avoid uremia. Second, to prevent the occurrence of cardiovascular and cerebrovascular complications so as to reduce mortality. Therefore, when serum creatinine level rises, Diabetic Nephropathy patients should also focus treatment on the control of blood sugar, blood pressure and blood cholesterol level and proteinuria reduction.

1. To control blood sugar level strictly

Diabetics first need to control their blood sugar level into required standard, namely HbA1c < 7%.

In the absence of contraindications, metformin should be the first choice for all glycemic regimens, and other antiglycemic drugs should be combined on the basis of metformin. SGLT2 inhibitor can be taken orally once a day. It is easy to use. If conditions are available, you can choose to use it.

2. To control blood pressure and reduce proteinuria

The blood pressure control goal of diabetic patients is blood pressure < 130/80mmhg.

Controlling hypertension is the most important treatment for delaying the progression of kidney disease and avoiding the progression of uremia. It can also reduce cardiovascular and cerebrovascular complications greatly.

-ACEI or ARB are preferred. They not only have antihypertensive effects, but also help reduce proteinuria and protect kidneys. When treating proteinuria, the dosage of ACEI and ARB can be 2~4 times of that of the antihypertensive dosage.

-On the basis of ACEI or ARB, other antihypertensive drugs can be combined, such as CCB and thiazide diuretics.

3. To control blood cholesterol level

The goal of blood lipid control for diabetic patients is: for type 2 diabetic patients aged > 40 years with cardiovascular risk factors, or who have had complications, low-density lipoprotein < 1.8mmol/L.

Statin lipid-lowering drug is the first-choice treatment. And it is recommended to take long acting lipid-lowering drugs such as atorvastatin and rosuvastatin.

4. To correct anemia

When creatinine level rises, Diabetic Nephropathy patients usually have anemia. And it occurs earlier and is more severe than that caused by other kinds of chronic kidney failure. Positive correction of anemia can improve the prognosis of patients.

The KDIGO guidelines recommend that hemoglobin levels should be controlled to >110g/L in patients with chronic kidney disease.

Drugs to correct anemia include intravenous or oral iron and erythropoietin.

5. To correct calcium and phosphorus metabolic disorders

When kidney function is damaged, most diabetics have calcium and phosphorus metabolic disorders, such as low calcium, high phosphorus, secondary hyperparathyroidism, and metastatic calcification, which should be corrected actively. According to your illness condition, you can take calcium supplements, calcitriol or phosphorus binders to improve survival rate and reduce the risk of mortality.

6. To improve lifestyle

Quit smoking, limit alcohol, reduce weight, exercise moderately, low salt, low fat, high quality but low quantity of protein diet.

What to do for Diabetic Nephropathy patients with elevated creatinine level? Now you get the answer. For more information, please leave a message below or contact online doctor.