Positive Urine Sugar Must Be Diabetes?

Ms. Liu, 32 years old this year, found that her urine sugar was (++) during a urine routine examination, which frightened her. Thinking about myself being thirsty and wanting to drink water recently, and my father having diabetes, I thought I might have diabetes. So I went to my outpatient clinic, and I checked her blood sugar, glycosylated hemoglobin, and rechecked her urine routine, and found that all the indicators were normal, and the urine sugar disappeared, which made her even more confused.

Click to cistanche herba for kidney disease

Does glucose also appear in normal human urine? In addition to diabetes, can other diseases also have positive urine sugar? Presumably, many people will have this doubt.

Urine sugar is not a specific manifestation of diabetes. Normal people and many other diseases (kidney disease, genetic disease, endocrine system disease) will also have positive urine sugar. Let me take you to understand it in detail.

In normal people, the glucose in the blood is actively reabsorbed in the proximal renal tubules after all the glomeruli are filtered, and no sugar is excreted in the urine. If the plasma glucose concentration is normal or below normal, the renal tubules will reabsorb all the filtered glucose. But in case of disease or elevated plasma glucose concentration, glucose starts to appear in the urine.

When the glucose concentration in the blood rises to a certain level, the reabsorption capacity of the renal tubules reaches saturation and cannot reabsorb excessive sugar. At this time, the maximum reabsorption rate of glucose in the renal tubules (TmG) is reached, and urine sugar begins to appear. , The blood glucose level measured when the urine glucose is positive is called the renal glucose domain, generally 8.9-10.0mmol/L[1].

This kidney disease can also lead to a positive urine sugar

Through the above, we learned that the reabsorption of glucose is in the proximal renal tubules of the kidney, so the appearance of glucose in the urine, in addition to common diabetes, is likely to be a problem with the kidneys, which is the most common urine sugar "+ ” is called Fanconi Syndrome (FS).

FS refers to the dysfunction of the proximal renal tubule, which leads to the reabsorption disorder and excessive excretion of various solutes processed by this segment of the nephron, mainly due to the excessive loss of urinary glucose, amino acids, phosphate, and uric acid. Disorders of non-selective functional defects of the tessellated tubules.

Clinical manifestations include renal glycosuria, renal aminoaciduria, proteinuria, and phosphaturia, often accompanied by electrolyte disturbance (sodium, potassium, calcium), urticaria, hypouricemia, rickets in children, and osteomalacia in adults, and even Decreased blood volume due to the combination of osmotic diuresis due to glycosuria and concentrating dysfunction secondary to hypokalemia occurs. It can be seen that FS has many accompanying symptoms besides the increase of glucose in urine.

FS is divided into two types: primary (also known as idiopathic) and secondary (also known as acquired). In the past, the syndrome was considered to be mainly a genetic disease, but more and more studies later proved that its etiology was mostly acquired [2]. Those with unknown causes are called primary or idiopathic and are mostly related to infants, children's heredity, or congenital metabolic disorders. Secondary FS can be seen in two situations, one is caused by genetic diseases, and the other is caused by drugs, heavy metals, or other diseases.

Primary FS

It is a rare genetic disease. Due to genetic defects such as HNF4A, proximal renal tubular dysfunction, and reabsorption are blocked, resulting in nutrient loss and electrolyte imbalance. The main manifestations are polydipsia, polyuria, growth retardation, and rickets. For the clinical and genetic studies of primary FS, there are only a few case reports in China, and there are few reports of genetically confirmed cases [3].

Secondary FS due to genetic disease [1]

Galactosemia

It is an autosomal recessive genetic disease, manifested as vomiting and diarrhea when babies drink milk, and then gradually develops jaundice, hepatomegaly, cataract, mental retardation, and FS. It can be detected by detecting enzyme defects in red blood cells, fibroblasts, or liver cells Diagnosed. A galactose-free diet can be used as the main treatment.

hereditary fructose intolerance

It is an autosomal recessive disorder caused by a deficiency of fructose-1-phosphate aldolase B. It is manifested as nausea, vomiting, and polyuria after eating fructose, and convulsions, coma, and death can occur if continuous consumption of fructose occurs. FS can occur rapidly after eating fructose and can be completely relieved in weeks or days after stopping taking fructose. The diagnosis can be confirmed by measuring the aldolase level in liver biopsy tissue, and the treatment is a strict fructose and sucrose restriction diet.

In addition, rare genetic diseases such as glycogen storage disease, cystinosis, tyrosinemia, Wilson disease, and Lowe disease can also lead to secondary FS.

Secondary FS due to non-genetic disease

Usually associated with lead poisoning, cadmium, expired tetracycline, toluene, gentamicin, streptozotocin, cisplatin, aristolochic acid, adefovir dipivoxil capsules, etc. Cancer, light chain deposition disease, Sjogren's syndrome, and other diseases secondary.

FS treatment

1. Stop using all drugs and poisons that may cause the disease, and actively control genetic diseases and other diseases.

2. Regulate electrolyte metabolism disorder, give alkaline drugs, supplement potassium, magnesium, phosphate, etc.

3. Supplement vitamin D.

4. For patients with renal insufficiency, symptomatic treatment should be given. If acute reversible factors are suspected, hormone and immunosuppressive treatment should be given actively.

5. Patients with advanced chronic renal failure can be given dialysis or kidney transplantation. But some genetic disorders, such as cystinosis, can recur in transplanted kidneys.

Other diseases that cause positive urine sugar

If there is elevated blood sugar at the same time, in addition to diabetes, some endocrine diseases that lead to secondary elevated blood sugar should also be considered, such as Cushing's syndrome, hyperthyroidism, and pheochromocytoma. In addition, in the event of traumatic brain injury, cerebral hemorrhage, acute myocardial infarction, and other diseases, excessive secretion of adrenaline and glucagon or stimulation of the medullary blood sugar center, leading to stress diabetes, urine sugar will also appear positive [4 ].

How does Cistanche treat kidney disease? 

Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.

Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Tristan may help treat kidney disease through several mechanisms.

Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help reduce high blood pressure, a common complication of kidney disease.

Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. Cistanche's antioxidant properties help neutralize free radicals and reduce oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.

Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammatory pathways, thus alleviating inflammation in the kidneys.

Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.

Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tub with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to impaired renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.

In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. Cistanche has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.

In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. Moreover, cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.

References:

[1] Wang Haiyan. Nephrology, 3rd Edition [M], Beijing, People's Publishing House, 2016: 1081

[2] Zheng Falei, Zhao Sumei, Li Xuemei, etc. Chinese Journal of Internal Medicine [J] "Clinical Features and Biochemical Abnormalities of Fanconi Syndrome", 2000, 39 (11): 735-738

[3] Gu Jie, Zhu Ruoxin, Li Dong, et al. Tianjin Medicine [J] "A Case Report of Primary Fanconi Syndrome Diagnosed by Genetic Analysis", 2018, 46 (4): 422-425

[4] Chen Wenbin, Pan Xianglin. "Diagnostics" 8th Edition [M], Beijing, People's Health Publishing House, 2013, 313