Kidney Disease (Nephropathy)
Our kidneys are special as they possess tiny blood vessels in the millions to do the work of filtering the blood to get rid of waste products from it.
There are times when the kidney’s filtering system fails, the damage resulting from diabetes. Kidneys that fail are no longer able to use its filters to remove the waste, and kidney disease results.
Diabetes leads to kidney disease
The process by which our bodies get the protein in our food digested produces some waste products. The kidneys’ minute blood vessels or capillaries, millions of them, have even more minute holes in them which do the work of filters. When blood moves through these blood vessels, waste products goes into the filters with other molecules to mix with liquids to form the urine. Red blood cells and proteins which are useful for the body, are not small enough to go into the filters and remain in the bloodstream.
This filter system can be damaged by diabetes. High blood glucose levels make these kidneys filter excessive amounts of blood. This additional work strain the filters and after some years, these filters begin to leak and some protein is sent out with the urine. When the urine contains only a small quantity of protein, it is known as microalbuminuria.
If diagnosis of kidney disease is early, when it is still microalbuminuria, a number of treatment can prevent the worsening for kidney disease. If the urine has big quantities of protein, it is known as macroalbuminuria. If diagnosis of kidney disease is made later, when it is already macroalbuminuria, ESRD, or end-stage renal disease , normally follows.
After some time, the strain of too much work results in the loss of the kidneys’ filtering ability. The waste products, instead of being filtered away, remains and accumulate in the bloodstream. Eventually, the kidneys can no longer perform. This inability to perform its filtering is serious enough to need a dialysis, in which a machine has to do the job of filtering the blood, or a kidney transplant .
Who can develop kidney disease?
Kidney disease does not develop in every diabetic. Blood pressure, blood glucose control and genetics are factors which can bring about kidney disease.
If blood pressure and diabetes are well controlled, there is lesser chance of developing kidney disease.
What symptoms can I expect?
Since the kidneys just had to work harder to cover for the failing filters in the capillaries, no symptoms are shown until practically every kidney function has been lost. There are no particular symptoms. Fluid increase can be the first possible symptom of kidney disease. Others can be difficulty concentrating, weakness, upset stomach, poor appetite, and insomnia.
It is important to see a doctor often, following a schedule. Organs to see if there are other diabetic complications, blood to look at waste products, urine to look out for protein, and blood pressure should be checked by the doctor.
Diabetic Nephropathy – Video Guide
How to prevent it?
By making sure that the levels of blood glucose is within your target range, diabetic kidney disease can be avoided. Research has indicated that the possibility of getting microalbuminuria can be lessened by about 35 percent if there is tight blood sugar control.For diabetics who has microalbuminuria, the chances of getting macroalbuminuria was lowered by 50 percent. Other studies also concluded that microalbuminuria can be reversed with tight blood glucose control.
Kidney disease treatments
Good control of blood pressure as well as blood sugar are necessary kidney disease treatments. The pace at which kidney disease worsens is affected by blood pressure. Kidney disease can worsen even if there is only a slight increase in blood pressure. Having regular exercise, avoiding tobacco and alcohol, consuming less salt and reducing weight are four ways to fight blood pressure.
If the above ways are unable to lower blood pressure, then medicines have to be used. Unfortunately, not every kind of drugs for blood pressure are just as good for diabetics. Some of these drugs can increase levels of blood glucose while others cover-up low blood glucose symptoms. For diabetics, doctors prefer to use those drugs for blood pressure known as ACE inhibitors.
For most patients with kidney disease, hypertension and diabetes, the recommended drugs are ACE inhibitors. Recent studies concluded that blood pressure can be lowered and kidney disease’s progress slowed with ACE inhibitors such as enalapril and captopril. These drugs have been found to be useful even in people without hypertension.
A diet with low-protein can be a treatment for macroalbuminuria. The kidneys seem to have to work harder when there is protein in the diet. This diet can lessen the loss of protein to the urine and add protein levels in the bloodstream. Talk to your health care team before beginning a diet of low-protein.
Dialysis is needed when the kidneys fail. The patient must decide between dialysis and a kidney transplant. Discuss with the health care team to get their help in making the decision. There should be the doctor, the diabetes educator, a psychologist, a kidney transplant surgeon, and a nephrologist or kidney doctor in the health care team.