Table of contents:
- What causes diabetic nephropathy?
- What are the symptoms of diabetic nephropathy?
- How to diagnose this condition?
- 1. Microalbuminuria urine test
- 2. Blood test blood urea nitrogen (BUN)
- 3. Serum creatinine blood test
- 4. Kidney biopsy
- How to treat diabetic nephropathy?
- Treatment of end-stage kidney disease
- What are the other implications of this complication?
Diabetic nephropathy is a type of kidney disease, namely nephropathy, which is a complication of diabetes. It is estimated that about 20-40% of people with diabetes mellitus will experience diabetic nephropathy if blood sugar is not properly controlled. This diabetes kidney damage can also be fatal if you ignore it. So what to do?
What causes diabetic nephropathy?
The kidneys are composed of thousands of tiny cells called nephrons that filter out waste or waste products in the blood. Furthermore, the remaining substances will be excreted out of the body through urine. Meanwhile, red blood cells and other substances that are nutritious for the body, such as protein, will be flowed through the blood vessels.
High or uncontrolled blood sugar levels can make the kidneys work harder to filter the blood. Slowly, the ability of the kidneys will decrease and cause the nephrons to thicken, until they leak. This can cause protein, such as albumin, to be wasted in the urine, causing diabetic nephropathy.
Apart from uncontrolled blood sugar levels, other factors that can increase the chances of diabetics experiencing complications of diabetic nephropathy are:
- High blood pressure
- Obesity or being overweight
- Have a history of type 1 diabetes before age 20 years
- Actively smoking
What are the symptoms of diabetic nephropathy?
The early stages of kidney damage often show no obvious symptoms. New disorders will appear and be felt when the kidneys really no longer function optimally.
You may not experience any symptoms until the kidney complications due to diabetes have progressed to a late stage. This final stage of kidney damage is known as kidney failure disease or ERSD.
According to the American Diabetes Association, the symptoms of diabetic nephropathy have no specific or characteristic symptoms so they can be difficult to notice quickly. Generally, the symptoms of kidney damage in the final stages include:
- Fatigue
- Overall feeling of unwell
- Loss of appetite
- Headache
- Hard to sleep
- Dry, itchy skin
- Difficulty concentrating
- Nausea or vomiting
- Swelling of the arms and legs
How to diagnose this condition?
Your doctor may order annual blood and urine tests to check for early signs of kidney damage. Common kidney function tests performed to diagnose diabetic nephropathy include:
1. Microalbuminuria urine test
The microalbuminuria urine test aims to check for the presence of albumin in your urine. Normal urine does not contain albumin. That is why, when protein is found in your urine, it indicates kidney damage.
2. Blood test blood urea nitrogen (BUN)
The BUN blood test, also known as blood urea nitrogen (NUD), checks for the presence of urea nitrogen in your blood. Urea nitrogen is formed when protein is broken down. High levels of abnormally high urea nitrogen in your blood may be a sign of kidney failure.
3. Serum creatinine blood test
A serum creatinine blood test is useful for measuring the creatinine level in your blood. Creatinine is a chemical waste product of muscle metabolism that is used during contractions. Later, the kidneys will remove creatinine from your body and excrete it together with urine.
If damaged, the kidneys cannot properly filter and remove creatinine from the blood. High creatinine levels in the blood can indicate that your kidneys are not functioning properly, but not always.
4. Kidney biopsy
The doctor may also perform a kidney biopsy. A kidney biopsy is a surgical procedure to take a small sample of one or both kidneys for analysis under a microscope.
How to treat diabetic nephropathy?
There is no cure for diabetic nephropathy, but proper treatment can slow or stop progression of the disease.
Checking your blood sugar and blood pressure regularly, using the correct insulin dose, and taking medication as directed by your doctor can keep blood sugar levels within a normal range.
Your doctor may also prescribe an ACE inhibitor, angiotensin receptor blocker (ARB), or other blood pressure medication to keep your blood pressure levels normal.
If needed, your doctor will also recommend a special diet that makes it easier for your kidneys to work. This diet is often a diet low in fat, sodium, potassium, phosphorus, and fluids.
Your doctor may also suggest a diabetes exercise plan for you to help control blood sugar levels and keep blood pressure within normal limits.
Treatment of end-stage kidney disease
If you have end-stage kidney disease, you may need dialysis or a kidney transplant.
Dialysis is a procedure using a special machine to filter waste products from your blood. Many people need dialysis treatments 3 times a week for 4 hours a day. You may need less or more maintenance than this schedule.
Meanwhile, to perform a transplant, the kidney from the donor will be placed into your body. However, the success of these two treatments can be different for each person and have their respective risks of complications.
What are the other implications of this complication?
The development of the disease depends on many factors. In some cases, diabetic nephropathy can cause eye damage from diabetes and heart disease. If it has developed into end-stage kidney disease, this condition can also cause death.
However, following a type 1, type 2 diabetes treatment plan, and living the recommended healthy lifestyle can slow the progression of the disease and keep your kidneys healthy for longer.
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