Kidneys are made up of millions of microscopic structures
called glomerulus. As with any blood vessel, high blood sugar in diabetes damages the blood vessels of
the kidneys also. Due to the prolonged damage, the filtration capacity of the kidneys decreases and they
become leaky. This damage to the kidneys due to high blood sugar in diabetes is called diabetic nephropathy.
If ignored, the damage will further continue unabated and a stage may come when the kidneys will stop
functioning, which is called kidney failure.
Apart from diabetes, smoking, hypertension, high
cholesterol and heredity are the major risk factors for diabetic nephropathy.
In the early stages there are no symptoms even if
your kidneys are continuously being damaged by hyperglycemia (high blood sugar). That is the reason you
should get regular urine tests for possible kidney damage on annual basis. The earliest problem (not
an overt symptom) will be that small amounts of protein from blood will start leaking out into your urine
(Called as microalbuminuria). The pathologist will check if there is any protein in your urine. Sometimes
microalbuminuria in its preliminary stage can be reversed by medicines.
If you do not control blood sugar and the initial stages of nephropathy go
undetected and untreated, your nephropathy gets worse. As a result, your blood pressure, cholesterol
and triglyceride levels rise. You may notice some swellings in your body, initially in the legs and feet.
The job of kidneys is to excrete the waste products
into urine and prevent protein and other nutrients from draining away into urine. The kidneys get leaky
in diabetic nephropathy. They are not able to filter the blood properly. So protein which should not
be found in urine is found in the affected person’s urine. A simple urine test will show whether
there is protein in the urine or not. The presence of the blood protein- albumin in urine is called microalbuminuria.
Early detection of diabetic nephropathy will help
getting it worse. This can be achieved by proper and timely medical treatment.
1) angiotensin-converting enzyme inhibitors or ACE inhibitors for short ;
2) Angiotensin II receptor blockers or ARBs for short
- To keep your blood pressure normal or near normal (below 130/80).
- To keep your cholesterol level in normal range (visit this page for more info on
cholesterol). You may need to take medication for lowering cholesterol.
- To keep your heart healthy by eating a low-fat diet and in particular diet having
no trans-fats and minimum saturated fats. Visit this page for more info on fats and oils.
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Exercising regularly. Visit this page for more info on exercise.
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Watch how much protein you eat. Eating too much will overload your kidneys. Most
doctors recommend that not more than 10% of your total calories should come from protein for patients
of diabetic nephropathy.
- Watch how much salt you eat. Eating less salt helps keep high blood pressure from
getting worse.
-
Don't smoke or use other tobacco products.
Preventing heart disease is most important for people
with type-2 diabetes, because they are 2 to 4 times more likely to have heart attack. People with diabetic
nephropathy are at higher risk for heart disease. Prevention or damage control for patients of diabetic
nephropathy can be accomplished if the following things are done:
- If you have type 2 diabetes, Start undergoing annual urine test for microalbuminuria at the time
you are diagnosed with diabetes.
- Watch intake of salt. Eating less salt helps keep hypertension under control. Don't smoke or use
other tobacco products.
Controlling blood sugar within normal or near normal
range is the basic requirement for prevention of diabetic nephropathy
Next comes the control of blood pressure. Keep it
below 130/85 if you are a diabetic. Cholesterol should also be kept under control.
Click here to go to Complications of Diabetes page
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