When diabetic patients have proteinuria, they can not think in accordance with the fixed thinking that they must have Diabetic Nephropathy. In fact, it may be primary glomerular disease when diabetic patients have proteinuria, which is diabetes combined with another kidney disease (non-diabetic kidney damage), rather than diabetic kidney damage. Here are some clinical clues for diabetes mellitus complicated with non-diabetic renal injury.

1. Most patients with type 2 diabetes mellitus complicated with non-diabetic renal impairment have a short course of diabetes. Most of them are within 5 years, and have a short period of time from the onset of kidney disease. Some patients have kidney disease at the same time or earlier than the onset of diabetes mellitus. There is no time correlation between the two diseases.

2. The prevalence and degree of blood pressure in patients with type 2 diabetes mellitus and non-diabetic renal impairment are lower than those in patients with diabetes mellitus, especially in the case of massive proteinuria or renal insufficiency.

3. It is not often for Diabetic Nephropathy patients to have hematuria. If diabetic patients have not only proteinuria, but also obvious glomerular hematuria, we should consider whether combined with non-diabetic renal damage.

4. Massive proteinuria (Nephrotic Syndrome) lasts for more than 2 years without renal impairment.

5. Diabetic nephropathy is a kind of microvascular injury, which is consistent with the progress of fundus microvascular injury. When diabetic nephropathy presents a large amount of proteinuria, it often also has fundus retinopathy at the same time. If there is no retinopathy, it is likely to combine with non-diabetic renal damage.

For the above cases, renal biopsy should be considered to make a definite diagnosis.

In clinic practice, the main types of pathological diagnosis of diabetes mellitus complicated with primary glomerular diseases are IgA nephropathy, membranous nephropathy, mesangial proliferative nephritis, focal segmental glomerulosclerosis (FSGS) and so on.

Now you know that diabetic patients with proteinuria are not necessarily Diabetic Nephropathy. What you should do firstly is to make a clear diagnosis. For more information on diabetes and kidney disease treatment, please leave a message below or contact online doctor.