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Diabetes Complications - Kidney Disease and Diabetes

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Kidney Disease and Diabetes

By Nina Nazor

How to Protect your Kidneys

Why is kidney disease caused by diabetes?

High blood glucose levels are toxic. When these high levels are sustained over a long period of time the arteries get damaged. Those arteries might be large, like the coronary arteries, or they can be as small and thin as a hair, such as the ones in the eyes or kidneys. That is why diabetes damages the eyes, the kidneys and is a risk factor for cardiovascular disease.

The good news is that with tight (strict) control you can prevent or delay the development of kidney problems. So, lets see what is kidney disease and all the things you can do to avoid it.

What is the function of the kidneys?

Our kidneys are the filters of our blood. They clean and recycle different substances and help get rid of toxic wastes through the urine using a very delicate and intricate network of blood vessels for their interchange of various substances.

How is kidney disease developed?

  1. Kidney disease in diabetes develops over the years. The first stage happens when the kidneys increase their filtering function. This process takes a few years to develop and is called hyperfiltration.
  2. Later, on the long run, the kidneys start leaking albumin (a protein present in the blood) into the urine. This is known as microalbuminuria. That is why you should have a test to detect microalbuminuria every year to check your kidney function.
  3. As kidney disease progresses the amount of albumin leaking into the urine increases. This stage is called diabetic nephropathy or macroalbuminuria. Then, the kidney's filtering function begins to slow down, the body starts retaining waste toxics due to the lack of filtration. Creatinine is one of those toxics, so the measurement of creatinine in urine can reflect the reduction in kidney function. When kidneys are damaged, blood pressure usually rises.
  4. The final stage is kidney failure. This often happens after having diabetes for up to 15 or 20 years. That is why strict control of blood glucose is so important to prevent the development of kidney problems.

What is the relationship between high blood pressure and kidney disease?

A family history of high blood pressure and/or the presence of hypertension increase the risk to develop kidney disease and hypertension speeds the progress of kidney disease when it already exists.

How to prevent kidney disease?

Antihypertensive drugs have shown to slow down the progression of kidney disease, especially angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). Also, in addition to an ACE inhibitor or an ARB, a diuretic is sometimes useful. Other blood pressure drugs may also be needed, such as beta-blockers and calcium channel blockers.

Diet

If you have diabetes, following a high protein diet can be harmful for the kidneys. Experts recommend that people with kidney disease and diabetes follow the guidelines for a healthy diet but avoid eating a high protein diet. When there is greatly reduced kidney function, it might be necessary to reduce the intake of protein in order to delay the onset of kidney failure.

Tight Control of Blood Glucose

Maintaining near normal blood glucose levels has shown great promise for people with type 1 and type 2 diabetes, especially for those in early stages of nephropathy.

Dialysis and Transplantation

People who develop kidney failure must undergo either dialysis or a kidney transplant.

Research

Several areas of research supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health hold great potential. Discovery of ways to predict who will develop kidney disease may lead to greater prevention in people with diabetes. Also, the discovery of better anti-rejection drugs will improve results of kidney transplantation and for some people with type 1 diabetes, advances in transplantation--especially transplantation of insulin-producing cells of the pancreas--could lead to a cure for both diabetes and the kidney developed by diabetes.

Source: National Kidney and Urologic Diseases Information Clearinghouse

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