Ok, so over the past couple of weeks, I’ve received several questions relating to the issues diabetics face in relation to kidney problems and how diabetes affects the kidneys, also known as nephropathy.
Diabetic nephropathy is the most common cause of renal failure, accounting for more than half of all cases of end-stage renal disease in the United States. Renal disease will affect between 20-40% of diabetics in their lifetime, so lets take a closer look at what its all about and more importantly, what we can do to avoid it!
Stop me if you’ve heard this one before, but as we’re aware, diabetes can affect many parts of the body, including the kidneys. In healthy kidneys, many tiny blood vessels filter waste products from your body. The blood vessels have holes that are big enough to allow tiny waste products to pass through into the urine but are still small enough to keep useful products (such as protein and red blood cells) in the blood.
High levels of sugar in the blood can damage these vessels over time if diabetes is not controlled. This can cause kidney disease, which is also called nephropathy (say: nef-rah-puh-thee). If your not well controlled and the damage is bad enough, your kidneys could stop working.
Signs And Symptoms Of Nephropathy:
Early signs and symptoms of kidney disease in patients with diabetes are typically unusual. However, signs and symptoms listed below may manifest when kidney disease has progressed:
- Albumin or protein in the urine
- High blood pressure
- Ankle and leg swelling, leg cramps
- Going to the bathroom more often at night
- High levels of blood urea nitrogen (BUN) and serum creatinine
- Less need for insulin or antidiabetic medications
- Morning sickness, nausea, and vomiting
- Weakness, paleness, and anemia
The differential diagnosis of diabetic nephropathy are extensive, but they include the following in a patient with known type 1 and type 2 diabetes:
- Primary or secondary glomerular disease
- Renovascular hypertension
- Renal artery stenosis
- Renal vein thrombosis
- Multiple myeloma
- Cholesterol embolization
- Chronic obstruction
- Interstitial nephritis
Diagnosis Of Nephropathy:
The first sign of kidney damage from diabetes is protein in the urine, which a doctor can measure in microscopic amounts, called microalbuminuria. Small amounts of albumin show up in the urine 5 to 10 years before major kidney damage happens.
If you have diabetes, like the majority of us do, your doctor will suggest regular monitoring of urine and blood tests to check the health of your kidneys.
Occasionally, a doctor may be concerned that kidney injury in a diabetic person is related to a separate problem. In that case, other tests such as ultrasound or a kidney biopsy may be recommended. In a biopsy, a small piece of kidney tissue is removed through a needle and examined in a laboratory.
Can kidney damage be reversed? When kidney damage is caught in its early stages, it can be slowed with treatment and dietary lifestyle changes. Once larger amounts of protein appear in the urine, kidney damage will slowly get worse.
Follow your health care provider’s advice to keep your condition from getting worse. Things that you can do:
Controlling Your Blood Pressure:
Keeping your blood pressure under control (below 130/80) is one of the best ways to slow kidney damage.
- Your doctor may prescribe medicines to lower your blood pressure and protect your kidneys from more damage. If your not a huge fan of taking additional medications like myself, eating a healthy diet as well as regular exercise are great alternative options for you to discuss with your doctor.
Controlling Your Blood Sugar Level:
I know, story of our lives, right? You can also slow kidney damage by controlling your blood sugar level, which you can do by:
Eating healthy foods (see my recipe section)
Getting regular exercise
Taking medicine or insulin as instructed by your health care provider
Checking your blood sugar level as often as instructed and keeping a record of your blood sugar numbers so that you know how meals and activities affect your level
Other Ways To Protect Your Kidneys:
- Before having an MRI, CT scan, or other imaging test in which you receive a contrast dye, tell the health care provider who is ordering the test that you have diabetes. Contrast dye can cause more damage to your kidneys.
- Before taking an NSAID pain medicine, such as ibuprofen or naproxen, ask your health care provider if there is another kind of medicine that you can take instead. NSAIDs can damage the kidneys, especially when you use them often.
- Know the signs of urinary tract infections and get them treated right away.
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Category: Diabetes Info