Diabetic nephropathy
In the United States, more than 100,000 people are diagnosed with kidney failure and about half of them are due to diabetes. People with diabetes are at a higher risk for kidney damage especially if the blood sugars are not well controlled. When you have diabetic nephropathy, you will lose the ability to filter the toxins in your body. In early stages of diabetic nephropathy, you may not have any symptoms. In some patients, diabetic nephropathy can eventually cause kidneys to stop working altogether and may need to go on dialysis.
Who is at risk for diabetic nephropathy?
Long-standing, uncontrolled blood sugars
Smoking
Being overweight or obese
African American’s, Hispanic and American Indians
If you already have other diabetes related complications like neuropathy, retinopathy, etc.
How is diabetic nephropathy diagnosed?
Diabetic kidney disease may take years to develop. Generally kidney damage is rare in the first 10 years of diabetes. If you are living with the diabetes for more than 30 years without any signs of kidney failure, the risk of developing kidney failure is very low. However, anyone with type 1 diabetes for more than 5 years and all people with type 2 diabetes should have urine test done every year.
There are 2 ways to check for diabetic kidney disease-
Urine albumin. Your health care provider will check for protein in the urine called albumin. As the kidney disease progresses, more albumin leaks into the urine. Kidney disease is present when urine contains more than 30 mg of albumin program of creatinine.
eGFR stands for estimated glomerular filtration rate. The kidney has filters called glomeruli. By estimating how much blood glomeruli filter in a minute will give us an idea how well the kidneys are functioning. If your eGFR is less than 60 mL/minute, that means you have kidney disease.
How do I protect myself from developing diabetic kidney disease?
- Strict blood sugar control especially in people who already have early stages of chronic kidney disease. This will include testing blood sugar frequently, dosing your insulin throughout the day based on your food intake and physical activity, following a strict diet and consulting your health care team regularly.
- Avoid high protein diets. For people with reduced kidney function, a diet containing reduced amounts of protein may help delay the onset of kidney failure.
- Blood pressure medications. Certain types of blood pressure medications called angiotensin converting enzyme inhibitors or angiotensin receptor blockers or effective in slowing down the progression of kidney disease. These medications not only control the blood pressure but even if you don’t have high blood pressure, these may directly protect the kidneys glomeruli. These medications are generally prescribed in people with the diabetes with even mild high blood pressure or if they have albumin in their urine.
- Keep your blood pressure below 130/80.
- Limit the amount of salt you eat
- Lose weight if your overweight obese.
- If you smoke, quit smoking.