The clinical manifestations of elderly diabetic nephropathy mainly include the following aspects. (1) proteinuria: early elderly diabetic nephropathy without clinical proteinuria, only microalbuminuria can be detected by radioimmunoassay. Clinical elderly diabetic nephropathy early manifestations of only proteinuria, proteinuria from intermittent gradually developed into continuity. (2) edema: clinical elderly diabetic nephropathy in the early general no edema, a small number of patients in the plasma protein before the reduction, may have mild edema. If a large number of proteinuria, plasma protein is low, edema increased, mostly for the progress of the disease to the late. (3) Hypertension: In patients with type 1 without nephropathy, the prevalence of hypertension is not higher than that of normal people. Type 2 diabetes suffers with high blood pressure, but the proportion of high blood pressure when proteinuria is also increased, In patients with nephrotic syndrome when patients with high blood pressure, most of this hypertension is moderate, a small number of severe. (4) changes in renal function: elderly diabetic nephropathy progress is very different. Some patients with mild proteinuria for many years, but normal renal function, and some patients with very little urine protein can be the rapid development of nephrotic syndrome, renal function gradually deteriorated, and ultimately uremia. (5) anemia: patients with significant azotemia, may have mild anemia. (6) Other: organ complications manifested as cardiovascular disease such as heart failure, myocardial infarction. Neuropathy such as peripheral neuropathy. Involving the autonomic nerve can occur when the neurogenic bladder. Retinopathy, senile diabetic nephropathy is almost 100% when combined with retinopathy, but there are serious retinopathy do not necessarily have obvious renal disease. When the elderly diabetic nephropathy progress, retinal lesions often accelerated deterioration.
Criteria for determining the severity of diabetic nephropathy in the elderly: elderly diabetic nephropathy can be pided into five. Phase 1: characterized by enlargement of the kidney and high filtration, characterized by increased urine volume and increased kidney volume by B-mode ultrasonography. 2: proteinuria after exercise, but normal blood pressure. 3: blood pressure higher than normal but not up to high blood pressure levels, known as early elderly diabetic nephropathy. 4: progressive proteinuria and hypertension are belong to clinical diabetic nephropathy. 5: the clinical manifestations of uremia, end-stage elderly diabetic nephropathy. The staging of 1-3 is non-clinical period having a different degree of reversibility, 4,5 period of disease progression, once the emergence of persistent proteinuria, almost without exception, the development of end-stage renal disease.