0–1.2 No restriction No restriction Stage 3A (overt nephropathy: early) ≥60 mL/min, overt proteinuria Normal 25–30 0.8–1.0 7–8 No restriction Stage 3B (overt nephropathy, late) <60 mL/min, proteinuria > 1 g/day Mild restriction Avoid overwork 30–35 0.8–1.0 7–8 Mild restriction Stage 4 (renal failure) Azotemia, proteinuria Moderate restriction AZD2014 in vivo 30–35 0.6–0.8 5–7 1.5 Stage 5 (dialysis) – Moderate restriction Hemodialysisb 35–40 1.0–1.2 7–8 <1.5 Avoid overwork CAPDb 30–35 1.1–1.3
8–10 Mild restriction aFor hypertension: less than 6 g/day bHemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients are catabolic. Total calorie intake should be slightly increased compared to DM patients. In CAPD patients, glucose is absorbed from PD fluid. References are the reports to MWL 1992, 1993 and Japan DM Association, 1999 Table 19-2 (b) Lifestyle modification for DM Foretinib price nephropathy (2) Stage Exercisea Work House work Pregnancy · Delivery Treatment, Diet, Daily life Stage 1 (pre-nephropathy) • Basically do exercise for DM • Normal • Normal OK • Control blood glucose, Avoid excessive PF-6463922 in vivo protein intake Stage 2 (early nephropathy) • Basically do exercise for DM • Normal • Normal OK • Strict control of blood glucose • Anti-hypertensive treatment • Avoid excessive protein intake Stage
3A (overt nephropathy: early) • Basically exercise is OK • Amount of exercise is dependent of the condition • Stop excess exercise • Normal • Normal Not allowed • Strict control of blood glucose • Anti-hypertensive
treatment • Protein restrictionb Stage 3B (overt nephropathy: late) • Restrict exercise • Slight exercise to maintain physical strength • Restrict exercise • Normal~slight restriction, depend on the job • Mild restriction • Work up to feel fatigue Not allowed • Control of blood glucose • Anti-hypertensive treatment, protein restrictionb • Water intake should be determined with Metformin price the degree of edema and congestive heart failure Stage 4 (renal failure) • Restrict exercise • Walking or warm-up exercise is OK • Slight restriction ~restrict job • Avoid fatigue • Stop over-work, No night shift • Restricted • Not overwork: feel no fatigue Not allowed • Control of blood glucose and hypertension • Low protein dietb (until dialysis) • Water intake should be determined with the degree of edema and congestive heart failure Stage 5 (Dialysis) • Basically slight exercise only • Stop excess exercise • Basically, mile restricted work • Avoid overwork, Restrict extra-work • Normal • Not overwork: feel no fatigue Not allowed • Control of blood glucose and hypertension • Dialysis or renal transplantation • Restrict water intake (inter-dialytic weight gain: less than 5% of ideal weight) aDegree of restriction is dependent on proteinuria or hypertension.