What is diabetic nephropathy?
When people with diabetes suffer alterations in blood glucose control among other factors, diabetic nephropathy originates. This can be one of the chronic complications of diabetes. Thirty percent of patients on periodic dialysis are caused by previous suffering from this disease. Likewise, diabetic nephropathy is the first cause of renal transplantation in the western world. This disease attacks the ability of the kidneys to carry out their main mission, to eliminate waste products and “extra” liquids from the body. All it takes is a healthy lifestyle and proper treatment of diabetes and high blood pressure.
Prognosis of the disease
It is a major cause of illness and death in people with diabetes. Early and accurate diagnosis in the first stages of the disease means that the kidney damage can be solved with medication. However, kidney damage worsens as larger amounts of protein appear in the urine. If this problem is perpetuated, it can lead to the patient needing dialysis or a kidney transplant. In addition, diabetic nephropathy can sometimes be accompanied by high blood pressure, heart disease and eye damage.
Diabetic nephropathy is the leading cause of kidney transplantation in the Western world.
Symptoms of diabetic nephropathy
In many cases there are no symptoms at the onset of the disease but it slowly worsens. This kidney damage may begin 5 to 10 years before the first symptoms appear. Some patients may show poor appetite, feel tired a great deal of the time and suffer general malaise. Other symptoms may include headache, nausea and vomiting, swollen legs, altered blood pressure, protein in the urine, increased need to urinate, less need for insulin for diabetes, confusion or difficulty concentrating, or fatigue. Regular blood and urine tests to diagnose protein loss in the urine and changes in kidney function as early as possible.
Medical tests for diabetic nephropathy
There are different medical tests available so that the physician can diagnose diabetic nephropathy in the least advanced stage possible. However, it is recommended that, once a year, the patient should have a urinalysis, in which the protein called albumin is analyzed and searched for. Sometimes the specialist may order a test for microalbuminuria, precisely to find small amounts of albumin. When the patient suffers from diabetes, the specialist performs a urine test to look for excess protein once a year, because too much protein is a clear sign of kidney damage. Arterial hypertension also sometimes accompanies diabetic nephropathy.
This type of hypertension develops very quickly or can become a difficult disease to control. The doctor will additionally check the kidneys every year through blood tests or other medical tests that can give information about:
- 24-hour urine protein
- Blood levels of phosphorus, calcium, bicarbonate, PTH and potassium
- Hemoglobin
- Hematocrit
- Urine protein electrophoresis
Finally, a biopsy of the kidney can confirm the diagnosis. Although the specialist sometimes does not need a biopsy to offer a correct diagnosis. The biopsy will only be performed on occasions when there are doubts about it.
What are the causes of diabetic nephropathy?
There are different factors that favor this renal disease:
- Time of evolution of diabetes. After 20 years from the onset of diabetes, 50% of patients may develop diabetic nephropathy.
- Arterial hypertension. This is the most serious risk factor in diabetics in the evolution of nephropathy.
- Glycosylated hemoglobin. There is a coincidence between the degree of glycemic control measured by the percentage of glycosylated hemoglobin and microvascular lesions. In addition, regular glycemic control slows down the development of glomerulosclerosis.
- Hyperlipoproteinemia.
- Obesity.
- Other risk factors. There are also other factors such as not controlling blood sugar levels, family members with diabetes or kidney problems, or smoking.
Can diabetic nephropathy be prevented?
The first step in the prevention of diabetic nephropathy is to consult a specialist and ask for a diagnosis without resorting to an MRI, CT scan or other imaging test in which the human body can receive a contrast medium that uses iodine. You should know that these dyes can affect and affect the patient’s kidneys in the long run. On the other hand, the specialist must know at all times at what point the disease is and avoid painkillers such as ibuprofen, naproxen and COX-2 inhibitors because they can damage the weakened kidney.
Treatments for diabetic nephropathy
With an adequate and personalized treatment for each person, it is possible to delay the real damage of a patient, as long as it is diagnosed at the beginning of the disease. As more and more protein appears in the urine, the kidney damage will slowly worsen.
In the event that this happens, there are three main pieces of advice to be followed by your specialist.
- Control blood pressure. Controlling blood pressure below 140/90 mm/Hg is a good way to delay kidney damage. Your doctor can prescribe medications to lower your blood pressure and protect your kidneys from further damage. Taking these medications can also help delay kidney damage, even if your blood pressure is in a healthy range.
- Control blood sugar levels. Eating a healthy diet, exercising regularly, taking medication or insulin always on a doctor’s advice or checking your blood sugar levels frequently can also delay the onset of kidney damage.
- Other ways to protect the kidneys. Avoiding taking analgesics such as ibuprofen or naproxen. Your specialist will be able to inform you correctly if there is another type of medication that you can take. These types of medications can damage the kidneys. Know the symptoms of urinary diseases and get the right treatment as quickly as possible. A low vitamin D level can also affect kidney disease. Your specialist will be able to prescribe vitamin D supplements if necessary.
Which specialist treats you?
The nephrologist is the specialist who can treat diabetic nephropathy. He or she is in charge of studying the kidneys and their diseases. The kidneys are very important organs in the human body and are responsible for maintaining a correct balance of fluid and electrolyte in the body. Top Doctors offers patients the best nephrologists specialized in diabetic nephropathy.