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Diabetes & Kidney disease

DIABETIC NEPHROPATHY – What is it?

  • Kidney disease due to diabetes is called as diabetic nephropathy. Diabetic nephropathy is the leading cause of kidney disease in patients starting on dialysis
  • Affects around 40% of diabetes patients.
  • Increases the risk of death and also increased risk of heart attack and stroke.
  • It is caused due to damage to the blood vessels – this causes leakage of protein into the urine – eventually kidneys lose their ability to remove waste products from the blood.

STAGES OF DIABETIC NEPHROPATHY: It usually progresses in different stages.

  • First stage is Microalbuminuria, in which protein starts to leak in the urine in very small amounts and is not detectable in urine by routine urine tests. It appears 5-10 years before major kidney damage happens. Patients typically do not have any symptoms during this stage.
  • Macroalbuminuria – is when amount of protein increases in urine.
  • Abnormal blood tests
  • Symptomatic stage

SYMPTOMS:

  • NO SYMPTOMS!! THIS IS THE BIG PROBLEM WITH KIDNEY DISEASE – By the time symptoms develop with kidney disease, the kidney disease is usually in fairly advanced stages. This is what makes it important for us to screen for it or look for it early on when we can prevent it from getting worse.
  • Ankle swelling
  • Fatigue
  • Nausea
  • Vomiting
  • Less urine formation

WHAT INCREASES THE RISK?

  • Uncontrolled diabetes
  • Increased blood pressure
  • Genetic tendency
  • Increased cholesterol
  • Smoking
  • Weight

HOW TO PREVENT KIDNEY FAILURE?

  • Good diabetes control – diet, exercise, medications
  • BP control – watch your salt intake – less then 5-6 g/day is recommended. Protein intake of 60 g per day as part of a healthy diet.
  • Certain medications can prevent or delay the onset of kidney disease
  • Cholesterol control
  • Aspirin
  • Stop smoking
  • Avoid NSAIDs – brufen, voveran, etc.
  • Regular kidney test including blood test and urine test in consultation with the physician.