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Diabetic Care Info
Diabetes Nephropathy
1. What are kidneys and how they work?
The kidneys are the body’s filtering and waste removal mechanisms. In the filtering process, blood flows through the blood capillaries and the waste substances that are not needed by the body are filtered out into the urine and passed on to the bladder.
- Remove wastes from the blood via the urine and return the cleaned blood back to the body.
- Regulate the levels of water and electrolytes in the body.
- Produce hormones that control other body functions.
2. Diabetic Nephropathy
Diabetic nephropathy is a chronic, progressive kidney disease that develops in one third of all diabetes sufferers. High blood glucose in the blood damages the small blood vessels throughout the body. When these blood vessels in the kidneys are damaged, the filtering process is affected. Wastes build up in the blood and other valuable substances such as proteins ‘ leak’ out into the urine. If this progresses, kidney damage can lead to kidney failure, also called end-stage renal disease (ESRD). At this time, the kidneys lose its function to clean the wastes out of the blood. Unless treated immediately, wastes build up in the blood to poisonous levels and eventually cause death.
3. What are the signs and symptoms of diabetic nephropathy?
In the initial phase, there are often no symptoms until the kidneys fail completely. Most of the time, the patients could have kidney damage without even being aware of it. Fortunately, there are some early signs or risk factors to watch for:
- Protein in the urine, Proteinuria.
- High blood pressure.
- Leg swelling or leg cramp.
- Increased need to urinate especially at night.
- Nausea and vomiting.
- Tiredness.
- Anaemia.
- Less need for insulin or anti-diabetic pills.
4. Are you at risk of getting diabetic nephropathy?
Diabetic nephropathy develops in one third of all people with diabetes. Here are some of the risk factors of diabetic nephropathy:
- Smoking.
- High blood pressure.
- Hyperglycemia.
- Family history of diabetic nephropathy.
5. What are the possible treatments for diabetic nephropathy?
There are not much treatment options for the patients with end stage renal failure. The main treatment options are:
- Hemodialysis
- Kidney transplantation.
Both hemodialysis and kidney transplantation are extremely invasive and expensive. Dialysis costs around USD35000 per person per year and the cost for kidney transplant is approximately USD15000 for the first year and then USD6000 per year thereafter. Therefore, efforts to prevent diabetic nephropathy progression to end-stage renal failure is extremely important. Regular screening of urine albumin level is essential to prevent the progression to end stage renal failure and omit the need for hemodialysis and kidney transplantation.
6. How to prevent the progression of diabetic nephropathy?
The public need to be aware of the risk factors of diabetic nephropathy. The measures that can be taken to decrease or delay their chance of developing it are as below:
- Maintaining good control of blood glucose level.
- Regular blood pressure monitoring to maintain at 130/80 mm/Hg.
- Regular screening of urine albumin excretion rate.
- Regular exercise.
- Stop smoking and alcohol drinking.
- Reducing dietary protein intake.
- Prompt treatment of urinary tract infections.
7. The future development of diabetic nephropathy
Although a cure for diabetes and diabetic nephropathy has not been found, the good news is that both of these diseases are preventable and it is now possible to slow down or stop the deterioration of these diseases. With a timely diagnosis, access to the appropriate medications, good medical advice and living a healthy lifestyle, a person with diabetes should be able to lead an active life and reduce the risk of developing complications especially diabetic nephropathy.
