The first question which comes to our mind is why is diabetes so bad for our kidneys. What causes the kidney disease due to diabetes? Well, to answer this question, we need to understand that when the insulin is unable to function efficiently in the body, the glucose accumulates in our blood leading to high glucose and sugar levels. With this, our body experiences increase in the level of blood glucose and this, in turn, leads to problems in different parts of the body. The condition injures the blood vessels of the kidneys which stop to function properly causing complications. This may finally result in the end-stage kidney failure.

Following are the two terms which are often associated with the condition:

Microalbuminuria: In this case, the amount of albumin that is excreted as part of the urine ranges between 30 and 300 mg in a day’s time. This condition if not treated early on might progress into what is called proteinuria.

Proteinuria: Hereby, the amount of albumin that passes through the urine per day is more than 300 mg. It is usually irreversible and the patient gradually declines into the end stage of the kidney disease.

Who Gets the Kidney Disease Due to Diabetes?

As per a few studies, 30 percent of the patients who have type 1 diabetes suffer from kidney failure due to diabetes while the percentage is somewhere between 10 to 40 percent for type 2 diabetic patients. Some factors which are responsible for the person getting or not getting kidney failure includes the level of blood glucose, blood pressure, as well as genetics.

A person who is better able to manage diabetes and keep the blood glucose levels under control stands a lesser chance of contracting kidney disease due to diabetes.

What Causes Kidney Failure in Diabetes?

When we eat and digest the food, waste products are created which are passed out of the body through the urine that we secrete. The tiny blood vessels which are present in our kidneys help in this particular process. Now with high blood glucose levels, severe damage is caused to these blood vessels. The kidneys begin to filter out too much blood and this entire process is very difficult for the filters responsible for this process. Hence, after a certain point of time, the filters start leaking. There is protein in the urine which starts to leak out.this process of letting protein out through urine is called microalbuminuria.

The chances of you getting diabetic kidney disease are much higher in the following cases:

• Overweight people and those who are not active.
• Patients who smoke.
• Have heart-related condition.
• Eat high amount of salt.
• African-Americans, American Indians are also more prone to developing the diabetic kidney disease much more than the others.

What is Diabetic Nephropathy?

Diabetic nephropathy is a term used for the kidney disease which people develop as a result of suffering from diabetes. Diabetes and Nephropathy have long been associated with diabetes causing high blood glucose or high sugar levels. Diabetes and kidney failure is something which affects a large population of diabetics across the world. People with diabetes suffer from all sorts of kidney problems such as:

• Infections in the urinary bladder.
• Nerve damage caused to the bladder
• Problems and distortions in the blood vessels of the kidney, amongst a host of other diseases.

It is also to be noted that kidney disease in type 1 diabetes is quite different from type 2 diabetes mellitus with diabetic nephropathy.

• In type 1, diabetic nephropathy mostly begins after almost a period of 10 years after contracting type 1
• In type 2 diabetes, most of the patients have already been suffering from the kidney disease before they have been diagnosed with diabetes.

What are the Symptoms of the Diabetic Kidney Disease?

The signs of kidney failure in diabetics are very gradual to come forth and sometimes there might not be any kind of symptoms at all.The early sign of renal failure could be:

• The excretion of large amounts of albumin in the urine. Due to this, you need to get regular check-ups of the urine done if you have diabetes.
• Weight gain is also possible during the early stages.
• Ankle swelling.
• Frequent urination, particularly in the night.

A few symptoms which may later develop include the following:

• Poor appetite
• There could be a loss of sleep.
• Swelling caused on the face and other parts of the body including hands and feet.
• Muscle twitching.
• Trouble in concentrating on anything that you do.
• Drowsiness and laziness.
• Nausea and vomiting.
• There is an increased level of potassium in the patient’s blood. Due to this, the heart rhythm is disrupted and becomes irregular.
• Weakness in the body caused due to loss of appetite.
• Itching and dry skin. This normally happens at the end stages of the disease.

Since there are no specific symptoms of the diabetic kidney disease, it is recommended that if you are a diabetic patient, you should go for regular check-ups for ensuring the sound health of your kidneys.

How is the Diabetic Nephropathy Diagnosed?

As per the American Diabetes Association, the following are a few ways in which you can get diagnosed with kidney failure caused due to diabetes:

• Blood tests are carried out to diagnose the condition. Most importantly blood tests are created to check the amount of creatinine in the blood. If the amount is raised, there is a problem with your kidneys.
• Checking the estimated glomerular filtration rate or eGFR as it is called is another way of detecting the efficient functioning of the kidneys
• Urine test to find out protein or albumin in the urine excreted.
• Tests are conducted to check the albumin to creatinine ratio.

What are the Stages of Kidney Disease Caused Due to Diabetes?

The diabetic kidney diseases pass through the following five stages:

Stage 1: This stage is the one which is often found even before the diagnosis of the diabetic kidney disease. It is concerned with hyper function and the usual features of this stage include albumin excretion through the urine of the patient. This condition is further aggravated at the time when the patient is involved in some or the other type of physical exercise.

Stage 2: In this stage, there is an increased GFR rate experienced by the patient.If diabetes is efficiently managed, during this stage albumin secretion through urine is minimal. However, when the patient indulges in any kind of physical activity, the secretion only increases. Stage 2 of the diabetic kidney diseases is actually the most common of all stages and develops slowly over a period of time. In fact, most of the patients continue in this stage throughout their lives.

Stage 3: This stage is known as incipient diabetic nephropathy. In this stage, a test known as radioimmunoassay is conducted to reveal the excessive amount of albumin excreted during urination. This is the very important phase of the diabetic kidney disease as the blood pressure of the patient also happens to be rising. GFR is considered to be super abnormal at this particular stage.

Stage 4: The chronic kidney disease stage 4 is known as overt diabetic nephropathy. This is mainly characterized by uncontrolled and very high blood pressure in the patients. In this case, the proteinuria is greater than 0.5 grams per 24 hours. In this stage, the patient is exposed to the high anti hypertensive treatment.

Stage 5: This is the end stage of the kidney disease and renal failure.At this stage, the patient suffers from uremia.

What are the Complications of Diabetic Nephropathy?

Diabetic nephropathy comes with a host of complications. Some of these include the following:

The major complication of diabetic nephropathy is that the patient develops what is known as chronic kidney disease which might even result in the kidney failure of the patient. This disease occurs slowly over a period of many years. What is worst about the chronic kidney disease it that as seen above, after it reaches a certain stage, the disease cannot be cured at all. Finally, the kidney disease is also closely related to heart-related diseases and the patients with diabetic nephropathy are at a greater risk of getting strokes or even heart attacks.

What are the Available Treatments for Diabetic Nephropathy?

Available treatments for diabetic kidney disease include the following:

ACE Inhibitors: These help in the treatment by reducing the amount of angiotensin II. These chemicals narrow down the blood vessels. Hence, the ACE inhibitors make the blood vessels relax and also reduce the high blood pressure. Thus, altogether these medicines reduce the progression of the kidney disease.

AIIRA: This work just like the ACE Inhibitors. In case a patient is allergic to the ACE inhibitors, the doctors usually prescribe these to them.

Keeping the Blood Pressure Under Control: In order to prevent the above-mentioned complications from the kidney disease and also to slow down the progression of the disease, it is very important that the patient controls the blood pressure level, either through medication or by adopting some changes in the lifestyle.

Keeping the Blood Glucose or Blood Sugar Under Control: Keeping the blood glucose levels under control is imperative to not only manage diabetes but also to delay any kind of progression of the diabetic kidney diseases. The balancing of the blood sugar also reduces the complications which might be the consequence of the kidney disease such as heart-related diseases, etc.

Treatment of Mineral and Bone Disorder: Special medicines are available for the treatment of the above.

Other Treatments: Some other treatments to reduce the impact of the diabetic kidney disease includes medicine to reduce the levels of bad cholesterol in the body, amongst a host of other treatments.

According to the National Kidney Foundation, if the kidneys have failed completely, the doctors prescribe three types of treatment. These are as follows:

• Hemodialysis: An artificial kidney is used to cleanse the patient’s blood. The doctor achieves that by making an entrance into the blood vessels.
• Peritoneal dialysis: In this method, the experts use the lining of our abdomen and a solution to clean the patient’s blood.
• Kidney Transplantation: As the name suggests, a kidney from a healthy person is transplanted into the body of the patient keeping various factors in mind.

How Long Can You Live on Dialysis with Diabetes?

As seen above, one of the treatments that help to cure kidney disease in diabetes is going for dialysis. But sometimes we do wonder how long can you live on dialysis with diabetes?

Well, as per the National Kidney Foundation, the life on dialysis depends on factors such as medical drugs you take as well as how the lifestyle is managed post you have been diagnosed with the problem. Having said that, the average span of life is somewhere around 5 years to 10 years. However, patients have even survived longer with dialysis done.

Tips to Avoid and Better Manage Diabetic Kidney Disease

A few changes and precautions in daily life can you better manage and sometimes even prevent the diabetic kidney diseases. Following are a few precautions that should be taken:

• Quit smoking.
• Limit the amount of salt that you eat as part of your food.
• Keep the weight under check. do make exercising a part of your daily routine.
• Eat a healthy and nutritious diet as advised by your doctor. Usually, people who do develop the diabetic kidney disease are recommended a diet which consists less of protein, sodium, potassium, as well as phosphorous.
• Limit the amount of alcohol you drink.
• Take medicines and drugs as and when prescribed by your doctor.
• Do remember that even after you start taking medicines to ensure that you are well managing and dealing with the diabetic kidney disease, it is important that you go for regular urine as well as blood tests and ensure that the medicines are working properly.

Hence, follow the above simple precautions and tips and manage diabetes in the best possible way.

We hope that the above post has been helpful in educating you more about diabetic nephropathy and how the same can be treated and managed effectively. This post further emphasizes the importance of treating and effectively managing diabetes as the condition involves a lot of complications. One such complication as dealt with in this article is diabetic kidney disease. After having read the article, we hope that necessary precautions will be taken and lifestyle shall be improved to avoid getting the disease!!