It is the disorder in filtering system of kidneys affecting the type 1 and type 2 diabetes patients. The waste substances present in the blood are cleaned by the small micro vessels called "Nephrons" which are found in the kidneys and if these are injured, it will lead to malfunctioning of the kidneys or permanent renal disease. Diabetic nephropathy can be cured by dialysis or renal transplant.
The diabetes will cause the nephrons to thicken and scarred and in turn causing the filtering capacity to become deliberate which will lead to fluid retention and a kind of protein called albumin that is released in the urine leading to diabetic nephropathy.
- Uncontrolled sugar levels
- High blood pressure
- Developing type 1 diabetes before 20 yrs
- Cigar smoking
- Family history of diabetes or kidney problems
- People who are African American, American inhabitants or Hispanic
During the early stages, there will be no symptoms found. Only when there is failure of the kidney, the signs occur:
- Feeling weakness all the time
- Pain in the head
- Feeling like vomiting and nausea
- Poor craving
- Inflammation of the legs
- Feeling ill generally
- Itchiness and dryness in skin
Your doctor would advise for certain blood and urine test to find the early signs of injury to the kidney.
Urine test to detect the presence of albumin, as the normal urine will not contain any protein and if present it shows damage to the kidney.
Blood test called BUN that detects the Urea Nitrogen in the blood. When protein is broke down, Urea Nitrogen is produced and when the levels are higher in the blood it signifies kidney failure.
Serum Creatinine test is done to find the occurrence of Creatinine in the blood. The kidneys work to eliminate the Creatinine by sending it to the bladder and thus excreting in the urine. If the levels are higher than the normal, it indicates improper functioning of the kidney.
Kidney Biopsy is a small procedure in which the samples from either one or both kidneys is removed and examined under the microscope for the scars. This confirms the Diabetic nephropathy.
There is no treatment for the early stages of Diabetic nephropathy but medications and certain other factors can delay the progress of kidney damage. By having good control over the blood sugar levels and blood pressure levels with proper medications and certain life style modifications, the progression can be deferred. But if the patient is in End Stage Renal Disease, then transplant is the only option.
Drugs – Intake of proper drugs and insulin prescribed by your doctor will help to keep your sugar levels and blood pressure range in control.
Changes in Life style - Your doctor would advise for some changes in your regular diet that will not affect your kidneys. The diet plan will consist of food with low sodium, potassium, fat, phosphorus and fluids. He may recommend for exercise plan too in order to maintain low pressure and kidneys in good position.
Treatment for ESRD – Dialysis followed by kidney transplant is the available treatment in addition to other management mentioned above. Dialysis is a process in which a special device filters the waste from your blood and the patients needs it three times a week. Transplant is a surgical intervention that involves placing of donor’s kidney into the patient’s body. The success of the transplant differs from each person.
The consultant would stop certain medicines that will injure the kidney if the patient’s condition progresses fast. Hence, Diabetic nephropathy is found to be one of the major leading causes for sickness and death in diabetes patients and requires proper attention.