Diabetes and Kidney Disease

Another common complication of diabetes is kidney disease. Although not all with diabetes develop kidney disease it is a real threat particularly for those with sustained high blood glucose levels. Other factors contributing to the development of kidney disease in diabetics is genetics and high blood pressure.

How does diabetes affect the kidneys? The kidneys serve as a filter of waste products during digestion of proteins in the food we eat. The kidneys are composed of tiny capillaries with even tinier holes acting as filters for waste products of protein digestion. Waste products are small enough to pass through these holes while protein and red blood cells being much bigger will normally not pass through. When a diabetic has sustained high blood glucose, the kidneys need to process a larger volume of blood. Over time the kidneys become overworked and the holes become larger allowing proteins to pass through to the urine. When small amounts of useful proteins find their way into the urine, this is a condition called microalbuminuria and is the first stage of kidney disease.

When diagnosed early or during the microalbuminuria stage, treatments can be availed to prevent it from progressing to macroalbuminuria. Macroalbuminuria is when huge amounts of useful proteins find their way into the urine. Sustained macroalbuminuria leads to the kidneys losing their filtering ability and the build-up of waste products in the blood. At this point, it is already an end-stage renal disease (ESRD) and the kidneys fail. A person with ESRD undergoes blood filtering via machine (dialysis) regularly and will require kidney transplant.

Preventing diabetic kidney disease is through effective blood glucose monitoring and control. Keeping the blood glucose under control in within the target levels means normal amount of blood for filtering by the kidneys. In fact studies show that strict blood glucose control reduces the risk of microalbuminuria by one third and even reverses it. This means that treatment plan to reduce blood sugar must be strictly followed. This includes insulin therapy, dietary and lifestyle changes.

Keeping blood pressure under control is also needed. This is done by dietary measures limiting the intake of bad cholesterol and salt and keeping weight under control. Doctors may also recommend a low-protein diet.

The symptoms of kidney disease are often unnoticeable in its earliest stage. Subtle symptoms include build-up of fluid, upset stomach, loss of sleep and loss of appetite. It is often in the advance stages where dramatic effects are felt and may already be too late. It is important to include protein check in the urine in regular check-ups particularly if one has the history of kidney disease.

By: Maricel Sanchez
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