High blood sugar in diabetes mellitus affects many organs inside body. This is the major reason behind the diabetes-generated complications inside body. One of the organs affected by diabetes is kidney. About 30% of patients with Type 1 diabetes and 10 to 40% of those with Type 2 diabetes eventually suffer from kidney failure.
The main job of the kidneys is to filter wastes and extra water out of the blood to make urine. Kidneys also help to control blood pressure and make hormones that body needs, to stay healthy.
HOW DIABETES CAUSES KIDNEY DISEASE?
With diabetes, small blood vessels inside body are injured. When the blood vessels in the kidneys are injured, the kidneys cannot clean blood properly. After many years, kidneys start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called micro albuminuria. The body also starts to retain more water and salt than it should be, which can result in many problems such as weight gain and ankle swelling.
Damaged nerves under diabetes can also lead to difficulty in emptying bladder. The pressure resulting from full bladder can back up and injure the kidneys. Also, if urine remains in the bladder for long time, it can develop infection from the rapid growth of bacteria in urine in the presence of high sugar.
EARLY SIGNS OF DIABETIC KIDNEY DISEASE
- Increased excretion of albumin in the urine
- Weight gain
- Ankle swelling
- Use the bathroom more at night
- High blood pressure
LATE SIGNS OF DIABETIC KIDNEY DISEASE
- Raised blood urea nitrogen (BUN) levels
- Raised creatinine levels
- Loss of appetite
- Increasing fatigue
- Muscle cramps (especially in the legs)
- Anemia (low blood count)
WHAT IS THE END STAGE KIDNEY FAILURE?
There are 5 stages of kidney disease, which are based on the presence of kidney damage and the glomerular filtration rate (GFR) (measure of the level of kidney function). As the chronic kidney disease progresses, GFR number decreases. The stages are:
|I||Kidney damage (e.g., protein in the urine) with normal GFR||90 or above|
|II||Kidney damage with mild decrease in GFR||60 to 89|
|III||Moderate decrease in GFR||30 to 59|
|IV||Severe reduction in GFR||15 to 29|
|V||Kidney failure||Less than 15|
End stage kidney failure occurs when the kidneys are not able to support in a reasonably healthy state and dialysis or transplantation is needed. This happens when the kidneys function at only 10 to 15%.
DIABETIC KIDNEY DISEASE TREATMENT
Treatment for diabetic kidney failure is based on the stage of kidney disease.
Maintenance of blood glucose levels: The best way to slow or prevent diabetes-related kidney disease is to try to reach the blood glucose and blood pressure goals. Healthy lifestyle habits and taking the medicines as prescribed can help to achieve these goals and improve the overall health.
Control blood pressure: Blood pressure is the force of your blood against the wall of your blood vessels. Highblood pressure makes your heart work too hard. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, angiotensin-converting enzyme inhibitors and angiotensin receptor blocker, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure.
Healthy lifestyle: Healthy lifestyle habits can help to reach the blood glucose
and blood pressure goals. This includes:
- Stop smoking
- Work with a dietitian to develop a diabetes meal plan and limit salt and
- Make physical activity part of the routine
- Maintain healthy weight
- Get enough sleep. Aim for 7 to 8 hours of sleep each night.
Dietary management: Another treatment some doctors use with macro albuminuria is a low-protein diet. Protein seems to increase how hard the kidneys must work. A low-protein diet can decrease protein loss in the urine and increase protein levels in the blood. Never start a low-protein diet without talking to your health care team.
Medication: Medicines are an important part of the treatment plan. Medicine can help to meet the blood glucose and blood pressure goals.
For controlling diabetes, opt for herbal anti-diabetic supplement such as Fenfuro (fenugreek seed extract) which is devoid of any known side effects as well as it is clinically proven to control diabetes.
For controlling kidney disease, the medications are based on the level of kidney damage.
Three types of treatment can be used once the kidneys have failed i.e.
- Hemodialysis – removing waste and extra fluid from blood
- Peritoneal dialysis – blood is cleaned inside the body, not outside the body
- Kidney transplantation – placing a healthy kidney from another person into your body