Diabetes is a condition characterized by high levels of sugar in the blood. It happens when the body does not produce enough insulin, a hormone that regulates the amount of sugar in your body. The resulting high sugar levels can lead to severe health complications such as kidney, heart disease, and vision loss.
Kidneys are vital organs that remove excess waste such as urea, creatinine, toxins, and other impurities from the blood. They also help to balance the body fluids, acid-base balance, salt, and potassium levels in the body. It is important for individuals with diabetes to prioritize their kidney health, as they face an increased risk of developing diabetes-related kidney diseases.
The link between diabetes and kidney health
Diabetes is one of the common causes of kidney disease. Kidneys are made up of tiny filters called nephrons. High blood sugadr can eventually damage the blood vessels and nephrons and affect their ability to function normally. Diabetes-related kidney disease is caused by several factors such as diabetes, and vascular alterations caused by co-morbid high blood pressure which can damage kidneys and lead to kidney disease. Diagnosing kidney diseases earlier can slow down the disease progression and help prevent kidney failure. It can also prevent cardiovascular complications as kidney diseases double the risk of cardiovascular disease.
Diabetic nephropathy- a consequence of diabetes
Diabetic nephropathy also known as diabetic kidney disease is a complication of type 1 and type 2 diabetes, it affects kidney function due to high blood sugar levels in the body and may lead to chronic kidney disease and end-stage renal failure. People with diabetes cannot process glucose from the food they consume, extra glucose in the bloodstream may damage the glomerular membranes. These glomeruli cannot filter the fluids and toxins and they accumulate in the body which may lead to kidney damage.
Signs and symptoms of diabetic nephropathy
In the early stages of diabetic nephropathy, symptoms may not be apparent. However, as the condition progresses, individuals may start experiencing various symptoms such as:
- High blood pressure
- Swelling
- Nausea and vomiting
- Shortness of breath
- Loss of appetite
- Fatigue
- Confusion
Risk factors for diabetic nephropathy
The following factors can raise the risk of diabetic nephropathy
- Uncontrolled hypertension
- Uncontrolled high blood sugar
- High blood cholesterol
- Smoking
- Obesity
- Family history
Diagnosis of diabetic nephropathy
Diabetic nephropathy is diagnosed with the help of different tests. These tests are a part of the regular diabetes tests . The most effective way to detect early kidney disease is to get an annual urine test which helps to prevent kidney damage at an early stage.
The other different types of screening tests include:
Urinary albumin test: This test can detect the blood protein called albumin in urine. Kidneys do not remove albumin from blood, the excess amount of albumin in the urine may indicate renal dysfunction. Normal levels of urinary albumin are below 30 milligrams per decilitre (mg/dL). Lower levels of albumin may indicate early kidney disease. You may be at a higher risk of developing heart disease if microalbumin is detected in your urine. Elevated levels of microalbumin may also be caused due to an acid-base imbalance in your blood, blood in your urine, and urinary tract infection.
Albumin/creatinine ratio (ACR): This test measures the ratio of how much albumin compared to creatinine is in the urine sample. Creatinine is a typical waste product found in urine and is a result of daily muscle wear and tear. A normal albumin to creatine ration is between 0 to 30 milligrams of albumin per gram of creatinine (mg/g). An ACR level between 30 to 300 mg/g might be indicative of early kidney disease. ACR levels of more than 300 mg/g might be indicative of more advanced kidney disease.
Glomerular filtration rate (GFR): This test measures kidney filtration rate by the amount of creatinine in the blood sample. A low rate indicates poor renal function. There are different stages of diabetic nephropathy according to estimated glomerular filtration rate (eGFR). The normal eGFR is about 100 and the lowest is 0.
Stage 1: GFR is 90 or higher at this stage and may have mild renal damage.
Stage 2: GFR can range from 60-89 at this stage and cause more damage to kidneys compared to stage 1, but the kidneys continue to function well.
Stage 3: GFR can range from 30-59 at this stage and may have mild to severe renal impairment.
Stage 4: GFR can range from 15-29 at this stage and may have severe loss of renal function.
Stage 5: GFR is below 15 at this stage and is at risk of renal failure.
Treatment for diabetic nephropathy
Diabetic nephropathy treatment depends on the stage you are in, age, and overall body health. It can be managed by consuming foods that are rich in fiber, managing your weight, exercising regularly, and quitting smoking. Treating early stages of diabetic nephropathy includes medicines to manage the following:
Blood Sugar: Medicines such as insulin, metformin, and glucagon-like peptide receptor agonists, help to control high blood sugar levels.
Blood Pressure: Medicines such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin 2 receptor blockers are used to treat high blood pressure.
High Cholesterol: Cholesterol-lowering medicines such as statins are used to treat high cholesterol and reduce urine protein levels.
Precautions to take if you have diabetes
The recommended precautions that individuals with diabetes should follow include:
- Monitoring blood sugar levels
- Monitoring high blood pressure
- Intake of prescribed ACE inhibitors
- Maintaining normal cholesterol and lipid levels
- Limiting the amount of protein and salt intake in your diet
- Avoiding medications that may damage the kidneys
Understanding the connection between diabetes and kidney diseases is crucial in the prevention and treatment of diabetic kidney diseases. Diabetes significantly increases the risk of developing kidney disease. It is important to manage blood sugar levels to maintain good kidney health. Early detection and regular screening can also help to improve kidney health outcomes.
