14 NOVEMBER -World Diabetes Day – Diabetic Kidney Disease
Diabetic kidney disease is a serious kidney-related complication of type 1 diabetes and type 2 diabetes. Type 1 diabetes usually occurs in children, also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus (IDDM). Type 2 diabetes is more common, usually occurs in people over 40 also called adult onset diabetes mellitus or non-insulin-dependent diabetes mellitus (NIDDM). Diabetic kidney disease (DKD) or diabetic nephropathy a kidney damage as a result of having diabetes. To date, no known cure for diabetic nephropathy, and treatment is lifelong. About 1 out of 4 adults with diabetes has kidney disease which mainly affects African Americans, American Indians and Hispanics/Latinos to develop diabetes kidney disease and kidney failure at a higher rate than Caucasians.
How does diabetes cause kidney disease?
The pancreatic islets of Langerhans are small islands of cells that produce hormones that regulate blood glucose levels. Hormones produced in the pancreatic islets are secreted directly into the blood flow by different types of cells: Alpha cells that produce glucagon hormone that raise blood glucose levels, Beta cells that produce insulin and amylin, insulin lowers blood glucose levels, Amylin slows gastric emptying, preventing spikes in blood glucose levels. Having diabetes for a longer time increases the chances to get kidney damage.
A condition characterised by high blood glucose (sugar) levels, in which the amount of circulating glucose (or sugar) in the bloodstream is higher than normal. When food enters the digestive system, it is broken down into glucose and enters the bloodstream. This triggers a process that makes the pancreas secrete insulin, When a person does not produce enough insulin, or if insulin is not used right away, this creates a build-up of glucose in the blood (hyperglycaemia) Over time the high levels of sugar in the blood damage the millions of tiny filtering units within each kidney. When small blood vessels begin to develop damage, both kidneys begin to leak proteins into the urine resulting to presence of high levels albumin.
This can lead to kidney damage and cause high blood pressure. High blood pressure can cause further kidney damage by increasing the pressure in the delicate filtering which eventually leads to kidney failure.
Predisposing factors are smoking, non-compliant to diabetes diet, eating foods high in salt, lack of exercise, overweight, high blood cholesterol, heart disease, and have a family history of kidney failure.
What Are the Diagnosis and Symptoms of Diabetic Nephropathy?
The test for determine the diabetic kidney diseases are Blood tests, Urine tests, Imaging tests (x-rays, ultrasound, CT, MRI,) scanning Renal function testing and Kidney biopsy. The first sign of diabetic kidneydisease (nephropathy) is presence of protein or albumin in the urine (microalbuminuria). As the kidney function worsens, later signs and symptoms may include: Swelling of the hands, feet, and face, trouble sleeping or concentrating, poor appetite, nausea, Weakness, Itching (end-stage kidney disease) and extremely dry skin, Drowsiness (end-stage kidney disease)Abnormalities in the hearts’ regular rhythm, because of increased potassium in the blood, Muscle twitching, and High levels of BUN and creatinine in the blood, shortness of breath.
How can you keep your kidneys healthy if you have diabetes?
Keep blood sugar levels in the normal range, control blood pressure, develop or maintain healthy lifestyle habits, manage your weight. Work closely with your health care team to ensure your urine albumin levels are being monitored. (The American Diabetes Association suggests that people with type 2 diabetes should be screened for urine albumin levels at the time of diagnosis and once a year thereafter.) Take medicines as prescribed: Angiotensin converting enzyme (ACE) inhibitors including ramipril (Altace) or angiotensin receptor blockers (ARBs) can help lower blood pressure, protect kidney function, vitamin D, statin: reduce the cholesterol, Pregabalin is used to treat pain caused by fibromyalgia, or nerve pain in people with diabetes (diabetic neuropathy). Treatment for advanced diabetic nephropathy is dialysis and kidney transplant.