Diabetes and Kidney Failure.



Diabetic Kidney Disease

The task of getting rid of waste in the blood and returning the filtered blood to the body is the main function of the two kidneys. When kidney failure occurs, the kidneys are no longer able to filter out waste and ensure the body has the right amount of salts and fluid needed by it.

Diabetes mellitus, a disease in which blood sugar levels are excessively high, is one of the causative factors of kidney failure. After some time, this excessive amount of blood sugar causes the breakdown of the multitude of small filters existing inside the kidney and culminates in kidney failure.

Kidney disease occurs in about 20 – 30 percent of diabetics. Fortunately, not everyone of these diabetics will eventually develop kidney failure. Nevertheless, regardless of whether insulin is used or not, the risk for nephropathy is present in all diabetics. The longer a person suffers from diabetes, the greater is the risk for nephropathy.

Treatment for diabetic nephropathy is for as long as there is life in the patient since it is incurable. It is also known as diabetic glomerulosclerosis. Risks faced by diabetics for other problems associated with the kidney include renal artery stenosis (RAS) or renovascular disease which involves arteries leading to the kidneys being narrowed.

Kidney Failure Symptoms

Kidney problems are only discovered at the time when a diabetic is having a medical check-up. Sometimes, people with type 2 diabetes do not even know he has it. The implication is that their high levels of blood glucose has not been known, therefore left unattended and so, have been wreaking havoc on their kidneys. During the check-up, high levels of protein in the urine may be the only factor to alert your doctor of kidney damage as there are no symptoms. By the time symptoms appear, years of damage may have taken place and serious damage has been done.

Below are some of the symptoms of kidney damage :

  1. Vomiting.
  2. Nausea.
  3. Headache.
  4. Fatigue.
  5. Bloating due to fluid retention, possibly in the legs or the face.

Diabetic Nephropathy – Video Guide

Kidneys Explained

The body possesses two kidneys with them situated below the ribs with each on one side of the vertebrae column. There are approximately a million nephrons in a kidney, with each nephron having a tiny filter connected by a tubule. The filters draw in liquid which carries waste in the blood and send it to the tubules. The waste and some of the liquid then form urine while most of the liquid is sent back to the blood through the tubules. Then, the urine in the tubules goes to the renal pelvis which is shaped like a funnel. From the renal pelvis, the urine moves down to the bladder through the ureter which connects the kidneys to the bladder.

From the bladder, the urine travels out of the body through the thin urethra. There will be a little protein in the urine, the situation known as microalbuminuria, if the kidneys suffer from diabetic nephropathy and cannot be as efficient as before. The kept liquid and salts lead to the retention of fluid with an increase in blood pressure often occurring.

The mechanism has yet to be understood

We know that diabetes is a risk factor for kidney disease but it is not known how high blood glucose can cause the glomeruli damage. It is a fact that hypertension can lead to kidney disease and diabetics are more susceptible to high blood pressure. The system which regulates blood pressure, known as the rennin-angiotensin system, is believed to be connected with the occurrence of diabetic nephropathy.

Other possible causes can be cigarette smoke and inherited genes. Nothing can stop the progress of diabetic nephropathy, not even medical treatment. Medical treatment can, however, slow down its progress by a lot.

Diagnosis Methods

There are various tests which can be applied to diagnose diabetic nephropathy.

  • Kidney Ultrasound : This helps to show from images seen whether arteries connected to the kidneys have become narrower, leading to poorer kidney function.
  • Biopsy : Using a thin needle, a tiny piece of tissue is taken from the kidney. The tissue is then taken to a laboratory to be examined. Biopsy is only carried out when there is uncertainty to the cause of kidney damage.
  • Blood Tests : Blood tests are used to find out the stage diabetic nephropathy has reached.
  • Blood pressure : Since diabetic nephropathy can raise blood pressure which also quickens its progress, it is important to check for increased blood pressure regularly.
  • Urine Tests : They are used to check the level of protein in the urine. An unusually big amount of protein found in the tested urine is an initial symptom of diabetic nephropathy.

Treatment Options

For diabetic nephropathy, no cure exists. The dependence upon treatment becomes greater with the kidneys heading for failure. The following are medical choices a

  • Kidney transplant : A healthy kidney donated by someone dead or alive can be transplanted into a patient to replace the failed kidneys.
  • Dialysis : Kidney failure is the last stage of kidney disease in which the kidney no longer can function. So, there is a need for an artificial kidney which can remove wastes while preserving fluid and salts as blood is moved through it. Another method, which is known as peritoneal dialysis, involves the removal of wastes from the fluids sent into the stomach. Dialysis is needed about three times a week for the remainder of a patient’€™s life.
  • Medications : Medications include those for lowering blood pressure which is high in order to limit damage to the kidney, such as the inhibitors of angiotensin converting enzymes (ACE) as well as angiotensin receptor blockers (ARB).
  • Prevention : Prevent is considered the best treatment. It involves control over blood pressure and blood glucose levels.

Ways To Reduce Risk.

A diabetic can lessen the possibility of getting diabetic nephropathy or slowing down its occurrence in various ways, such as:

  • Not having the kidney stressed with such things as contrast dyes injected into the body for the purpose of certain X-rays.
  • Taking a lot of non-alcoholic fluids, especially water.
  • Giving immediate attention to the treatment of urinary tract infection with antibiotics.
  • Not taking non-steroidal anti-inflammatory drugs (NSAIDS).
  • Ensuring that blood pressure is under good control.
  • Good control of blood glucose levels.(see Tight Blood Sugar Control)
  • Know the condition of your kidneys with regular tests.

Brief Overview

  • Diabetes mellitus, with its typically high levels of blood glucose, is one of several risk factors of kidney failure.
  • After some time, the large amount of blood glucose will cause damage to the huge number of minute filters that each kidney has.
  • Since there exists no cure for kidney disease, treatment has to be intensified as the kidneys worsen on its path to failure.
  • The choices of treatment are use of medicine, dialysis with an artificial kidney and having a donor kidney transplanted.
*** Posted By Natasha A.Nada ***