Diabetic Nephropathy or Diabetic Kidney Disease

What is Diabetic Nephropathy? | What is the first sign of Diabetic Nephropathy / Diabetic Kidney Disease? | Prevalence | Symptoms | Causes and Risk Factors | Diagnosis | Treatment | Treatment for advanced diabetic nephropathy | Prevention | FAQs

Initial stage there are often no symptoms. The early sign of diabetic kidney disease is an increased excretion of albumin in the urine, we advise all to do yearly checkup so that Diabetic Nephropathy (Figure 2) can be identified in initial stages. 

The prevalence of DN is mostly in Type 2 diabetic patients, 20-40% with microalbuminuria (MA) progress to manifested nephropathy after 20 years from the onset of diabetes; approximately 20% develop end-stage renal disease (ESRD).

The risk of developing diabetic nephropathy (DN) starts with albuminuria, progressing from microalbuminuria to macroalbuminuria. It is recommended that all Type 2 diabetic patients should do annual microalbuminuria urine test, starting at the time of diagnosis. This prevalence was ranging between 25% in patients younger than 65 years old to nearly 50% with age older than 65 years (22)

As the kidney function worsens, these signs and symptoms indicate Diabetic Kidney Disease :

• Nausea, Vomiting and Poor appetite
• Anemia (a low blood count)
• High blood pressure
• Morning sickness
• High levels of BUN and creatinine in blood
• Trouble sleeping or concentrating
• Difficulty thinking clearly
• Weight loss
• Drowsiness
• Extremely dry skin and itching
• Muscle cramps (specially in your legs)
• Weakness, paleness
• Fluid retention due to that swollen feet and ankles
• Puffiness around the eyes
• Needing to pass urine more frequently

High blood sugar, can damage the blood vessels in your kidneys due to that they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys.

Your risk of Diabetic Kidney Disease is greater if you have type 1 or type 2 diabetes. Several other factors may increase your risk of Diabetic Kidney Disease that includes:

• Smoking
• High blood pressure (hypertension)
• High cholesterol (hypercholesterolemia)
• High blood sugar (hyperglycemia)
• A family history of kidney disease and diabetes

To determine whether you have diabetic kidney disease, these tests and procedures can help, such as:

• Blood tests. If you have diabetes, you will need blood tests to check levels of BUN and creatinine and monitor your condition that will determine how well your kidneys are working.
  
  
• Urine tests. Urine samples provide information whether you have too much protein in the urine. High levels of a protein (microalbumin) may indicate your kidneys are being affected.
  
  
• Imaging tests. X-rays and ultrasound are advised to assess your kidneys' size and structure. Some of the cases CT scanning and magnetic resonance imaging (MRI) will ne advised to determine how well blood is circulating within your kidneys.
  
  
• Renal function test. to assess your kidneys' filtering capacity using renal analysis testing.
  
  
• Kidney biopsy. After other diagnostics, nephrologist may recommend a kidney biopsy to remove a sample of kidney tissue. Watch here details about Kidney Biopsy

Medications: In the early stages of diabetic nephropathy, treatment plan may include various medications to control the causes of it:

• Manage and Control high blood sugar: Keep track of your blood sugar levels to see what makes them go up or down; eat at regular times, and don't skip meals; choose foods lower in calories, saturated fat, trans fat, sugar, and salt; Track your food, drink, and physical activity; Drink water instead of juice or soda.
  
  
• Lower high cholesterol: Reduce saturated fats that found primarily in red meat and full-fat dairy products that can raise your total cholesterol; eliminate trans fats; eat foods rich in omega-3 fatty acids; increase soluble fiber.
  
  
• Controlling protein albumin in the urine: Follow dietary changes, try to maintain healthy weight. Losing weight can manage conditions that impair kidney function; blood pressure medication and diabetes medication can help in controlling protein in Urine (proteinuria), and lastly dialysis that filters and purifies the blood using a machine.
  
  
• Maintaining healthy bones: Include plenty of calcium in your diet and physical activity in your daily routine, pay attention to vitamin D, avoid substance abuse like don't smoke and avoid drinking alcohol.

When it progresses to end-stage kidney disease (kidney failure), doctor will help you in focused care on managing the function of your kidneys to make you more comfortable, such as:

• Dialysis: Dialysis is a treatment that filters and purifies the blood using a machine. This helps keep your fluids and electrolytes in balance when the kidneys can't do their job. Dialysis has been used since the 1940s to treat people with kidney problems.
  
  
• Kidney transplant: A kidney transplant is a surgical procedure to place a healthy kidney from a living or deceased donor into a person whose kidneys no longer function properly.
  
  
• Managing Symptoms: If you choose not to have dialysis or a kidney transplant, your life expectancy generally would be only a few months. Doctor likely to work on management of the diabetic nephropathy symptoms to help keep you comfortable.

In the future, people with diabetic nephropathy may benefit from regenerative medicine treatment. This technique may help slow down or reverse kidney damage caused by the disease. This technique, however, are still investigational. In addition, researchers are testing stem cells technique and several new medications for diabetic kidney disease.

Lifestyle habits can support your blood glucose and blood pressure goals. Depending on your situation, kidney function and overall health, these may include:

• Maintaining a healthy weight - limit portion size to control calorie intake, be as physically active as you can be, talk to your doctor about your weight if you think that you weigh too much or too little.
  
  
• Being active - make habit for at least 30 minutes of physical activity most days of the week.
  
  
• Stop smoking and alcohol intake - If you're a smoker then quitting smoking will help to reach goals.
  
  
• Get enough sleep - make habit for 7 to 8 hours of sleep each night.
  
  
• Adjusting your diet - Work with a dietitian to develop a diabetes meal plan and limit salt and sodium.

Request an appointment at Pace Hospitals - Department of Nephrology and Kidney diseases

Request an appointment at Pace Hospitals - Department of Nephrology and Kidney diseases