Diabetes is the cause of over 40 per cent of kidney failure cases, and is the most common cause of ESKD (end stage kidney disease) which is the fifth and end stage of diabetic neuropathy. Do bear in mind that not all diabetic patients automatically progress on to ESKD.

When a person has either type 1 or type 2 diabetes, there is a chance of progressing on to a disease called diabetic nephropathy or diabetic kidney disease.

Diabetic nephropathy is a progressive kidney disease, with the risk increasing during the lifespan of the disease, coupled with other risk factors like a family history of kidney disease and high blood pressure.

The disease affects the efficiency of your kidneys to remove waste products and extra fluid from your body system. Damaged kidneys will lead to high blood pressure. It slowly damages the kidneys delicate filtering system over the years. ESKD is a life-threatening condition leaving a patient with 2 options which are either dialysis or a kidney transplant.

Early intervention with proper medical treatment can slow down or halt the progression of diabetic nephropathy, as it progresses slowly. However, kidney damage in the initial stage does not have noticeable symptoms, and normally becomes apparent when a patient is in the later stages of chronic kidney disease.

In later stages, diabetic nephropathy displays the following signs and symptoms:

  • uncontrollable blood pressure
  • confusion
  • fatigue
  • swelling in the extremities, i.e., arms and legs
  • increased need to urinate
  • reduced need for insulin (diabetic medication)
  • loss of appetite
  • itchy skin
  • nausea or vomiting
  • headache
  • protein in urine

As diabetic nephropathy progresses slowly, complications will develop gradually over months or years, some of which are:

  • hyperkalemia – a rise in potassium levels in the blood
  • cardiovascular disease which could possibly lead to a stroke
  • anemia – lack of healthy red blood cells
  • fluid retention in the extremities or lungs
  • high blood pressure
  • retinal damage (diabetic retinopathy)
  • nerve damage resulting in foot sores, or ed (erectile dysfunction)
  • ESKD (end stage kidney disease)

Treatment options:

Your doctor will be able to offer treatments according to the severity of your diabetic nephropathy, the first being to treat and control your diabetes and hypertension if you have it.

Three treatment options which are currently available are medications, kidney dialysis and kidney transplant. In the pipeline though not approved yet, is treatment being developed using regenerative medicine, e.g., stem cell therapy.

Prevention of diabetic nephropathy:

Assuming you are a diabetic, here are a few suggestions to possibly reduce your risk of developing diabetic nephropathy:

  • Ensure your diabetes is under control – effective treatment and medication may prevent the onset of diabetic nephropathy.
  • Control high blood pressure – consult your doctor on how best you can control your blood pressure.
  • OTC (over the counter) prescriptions – certain pain relivers can lead to kidney damage for patients suffering from diabetic nephropathy. Get your doctor’s clearance before taking OTC prescriptions.
  • Maintain a healthy lifestyle – talk to your doctor who may refer you to a dietician who can provide proper dietary information.
  • Weight control – if you are already at a healthy weight level, take steps to draw up a daily exercise plan to maintain it. If you are overweight, discuss this with your doctor or dietician who can draw up a diet plan according to your caloric intake requirements.
  • Give up smoking – research has shown cigarette smoking does cause damage to your kidneys, and worsen or speed up existing kidney damage. Your doctor can put you on medication, or put you in touch with counsellors and support groups to help you give up this bad habit.

This is a very basic and simplified summary on diabetic nephropathy. Readers, especially diabetic patients, are advised to consult your medical practitioner for proper diagnosis, treatment options, etc.

By Aaron
16th June 19:30

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