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Diabetic Nephropathy

The document discusses a 55-year-old diabetic woman with multiple health issues including hypertension, obesity, knee pain, dyslipidemia, and anemia. It highlights the importance of recognizing diabetes as a leading cause of chronic kidney disease and outlines a treatment plan focusing on lifestyle changes and medication management. Prevention is emphasized as a crucial approach to managing diabetes and its complications.

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Kandy Emmy
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57 views15 pages

Diabetic Nephropathy

The document discusses a 55-year-old diabetic woman with multiple health issues including hypertension, obesity, knee pain, dyslipidemia, and anemia. It highlights the importance of recognizing diabetes as a leading cause of chronic kidney disease and outlines a treatment plan focusing on lifestyle changes and medication management. Prevention is emphasized as a crucial approach to managing diabetes and its complications.

Uploaded by

Kandy Emmy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd

Just an every day patient …..

55 years old Diabetic lady


occasional breathlessness
Occasional sweating
Otherwise asymptomatic

Bilateral Knee pain


( uses Noppi mandaloo on n off )
O/E
pallor +
BP 150/84 mm hg
wt 70 kg
Ht 155
BMI 29
CVS / RS / PA unremarkable
R e p o r t s ……
Hb 9.7 gm%
TLC 10000 plat 1.8 lakhs
FBS 167 PLBS 215
FLP Chol 222 TG 289 HDL 33
Creat. 1.4
Urine R/E protein trace RBC nil PC 2-3
ECG T inversion from V1 to V3
Urine for micro albumin 52
Here s her prescription …..
Metformin 500 mg OD
Atenolol 50 mg od
Atorvastatin 10 mg ( stopped 6 months )
She has been to many GPs
What do you think she needs ….
Problems ?
Diabetes Mellitus
Systemic Hypertension stage
Obesity grade 1
B/L OA
Dyslipidemia
Anemia
? Causes
Chronic Kidney Disease
Why we need to recognize this
entity ?
Diabetes is spreading like an epidemic
India the diabetic capital of the world
AP … soon be the diabetic capital of India

DM is the most common single cause of ESRD


30-40% of Diabetics develop nephropathy
5-10 % its present at the time of diagnosis
Definition & Classification
Microalbuminuria 30 – 300
Macroalbuminuria > 300

Carl Erik Mogensen s describes


Stage I >90 renal hypertrophy ( 5
yrs)
Stage II 60 – 89 Normalcy
Stage III 30 – 59 Microalbuminuria
Stage IV 15 – 29 overt nephropathy
Stage V < 15 ESRD
Beyond stage IV
So what do we do?
4 H need to be handled

H Habits
H Hyperglycemia
H Hypertension
H Hyperlipidaemia
Treatment
N NO Smoking
E Exercise
P Pneumococcal vaccination
H Hypo/Hyperglycaemia to be avoided
R Ramipril
O Overweight / Orlistat
P Protein Restricted Diet
A Anemia to be corrected
T Toxins to be avoided
H Hypo/Hypertension to be corrected
Y Yoga ( Meditation )
Prevention is always better than CURE

for sometime PREVENTION may be the only


ANSWER we may have
Thank you for your kind attn.

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