Diabetic Nephropathy – Symptoms, Causes and Treatment

Diabetic nephropathy is another term for diabetic kidney disease. Plainly put, it is kidney damage caused by high blood sugar levels. This condition is caused by long-term type 1 and type 2 diabetes.

The kidneys’ primary function is to remove waste from the blood and return the cleaned blood to the body. Diabetes impairs this normal kidney function and causes waste materials and fluids to accumulate in the body, leading to kidney damage or diabetic nephropathy.

Diabetic nephropathy can be slowed, stopped, or even reversed in its starting stages if detected and treated early.

Symptoms:

Early diabetic nephropathy often has no symptoms. As kidney function deteriorates, the following symptoms may occur:

Having difficulty sleeping or concentrating
Nausea and vomiting
Persistent itching as well as extremely dry skin, especially during the end-stage.
Drowsiness (end-stage kidney disease)
Abnormal heart rhythm is caused by increased potassium in the blood.
A decline in blood pressure control.
Swelling of the feet, ankles, hands, or eyes
Increased need to urinate
Reduced need for insulin or diabetes medication
Shortness of breath
Loss of appetite
Fatigue

Risk factors:

The following are some risk factors of diabetic nephropathy:

Uncontrolled high blood sugar
Uncontrolled high blood pressure
High blood cholesterol
Smoking
Family history of diabetes and kidney disease

Prevention:

Diabetes patients can reduce their risk of diabetic nephropathy or delay its onset by following these prevention measures.

Maintain control over blood sugar levels (target: HbA1c 7%).
Maintain normal blood pressure (target: 130/80 mmHg).
Adopt a low-salt, low-meat, low-saturated-fat diet.
Make sure you get enough exercise (at least 150 minutes per week, for example, 30 minutes five days a week)
Maintain a healthy BMI between 18.5 and 22.9.
Quit smoking
Limit alcohol consumption.
Get diagnosed regularly

The progression of end-stage kidney disease can be prevented or delayed by taking the prescribed medications and making necessary lifestyle changes.

Diagnosis:

The following are the main tests used to determine the presence of diabetic nephropathy and how well your kidneys are functioning:

Blood pressure – Diabetic nephropathy causes elevated blood pressure, which also contributes to its progression. Therefore, regular monitoring of blood pressure is important.
Urine tests – Urine tests are used to determine protein levels. One of the initial symptoms of diabetic nephropathy is an abnormally high level of protein in the urine.
Blood tests – Blood tests are used to determine the level of kidney function. The amount of creatinine in a blood sample can be used to estimate how quickly the kidneys filter blood.
Kidney ultrasound – An ultrasound images the kidneys’ size and checks if the arteries leading to the kidneys have narrowed, which can impair kidney function.
Biopsy – Biopsy entails removing a small piece of tissue from the kidney with a thin needle and examining it in a laboratory. This is usually only done when it is unclear whether the kidney damage is the result of diabetes or something else.

Treatments:

Diabetic nephropathy can be effectively treated if detected early. The following are the specifics of how it can be managed:

Medications:

Blood pressure medications such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are used to control high blood pressure.
Medications are used to control high blood sugar levels.
Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications. Statins are given to lower high cholesterol levels in the blood.
Treatment also includes medications that regulate the level of albumin in the urine.

Kidney Dialysis:

Diabetic nephropathy can be managed in its late stages only with the help of kidney dialysis. Dialysis consists of either shunting the patient’s blood through a special machine that helps remove waste while preserving water and salts (hemodialysis) or removing waste through fluid introduced into the abdomen (peritoneal dialysis).

Kidney Transplant:

End-stage diabetic nephropathy can also be treated with a kidney transplant. In this process, the infected kidneys are replaced with a healthy donor kidney obtained from a deceased person or a relative or friend.

Answers to a few Frequently Asked Questions:

Is it possible to prevent kidney damage from worsening?

It may be possible to stop or slow down the progression of kidney disease. Because high blood pressure is one of the major predictors of diabetic nephropathy, it is critical to take your high blood pressure medication on a consistent basis if you have high blood pressure. Your doctor may also advise you to follow a low-protein diet to reduce the amount of work your kidneys would have to do. You should also stick to your diabetic diet and take all of your prescribed medications.

How many diabetic nephropathy patients develop total kidney failure?

About 30% of people with Type I diabetes and 10% to 40% of people with Type II diabetes will start developing end-stage kidney failure, necessitating treatment to keep them alive.

How long does it take for the kidneys to be affected?

Within two to five years of being diagnosed with Type I diabetes, almost all patients develop some symptoms of functional change in the kidneys. Approximately 30 to 40% progress to more serious kidney disease, usually within 10 to 30 years.
Type II diabetes has a less well-defined course, but it is assumed to follow a similar pattern, except that it occurs at a later age.

How can a diabetic patient know if the kidneys are affected?

If you have diabetes, have your kidneys checked on a regular basis by your doctor through simple blood and urine tests. Regular screening is the best way to detect diabetic nephropathy early.

Apollo Homecare:

Early detection can be your best bet against preventing Diabetic Nephropathy. We at Apollo Homecare provide a Diabetes Care Partnership Program that aims to ensure a strict sugar intake plan and the prevention of target organ damage for a stress-free daily life. Our multidisciplinary care team, which includes a primary physician, nurse, dietician, physiotherapist, and lab pathologist, work with you to assess and manage your diabetes.