Treatment of patients with diabetic nephropathy involves taking care of several issues such as medicines to treat diabetic nephropathy, blood sugar control, management of hypertension and dietary changes. Read to know more on treatment of patients with diabetic nephropathy:
- Medicines to treat diabetic nephropathy: Medications used to treat diabetic nephropathy are medicines that control blood pressure such as the Angiotensin-converting enzyme (ACE) inhibitors (such as captopril, lisinopril, ramipril, and enalapril) and Angiotensin II receptor blockers (ARBs) (such as candesartan cilexetil, irbesartan, losartan, and telmisartan). The ACE inhibitors and ARBs may reverse the kidney damage in initial stages of disease (when there is very small amount of protein in your urine). The ACE inhibitors have been shown to reduce the risk of heart and blood vessel (cardiovascular) disease. Some people may be given an ACE inhibitor along with an ARB. Some studies suggest that combination of these medicines may be more effective in protecting the kidneys than either of these medicines alone.
- Treatment of hypertension: Diabetic nephropathy can cause rise in blood pressure, which can further worsen the kidney damage. According to the American Diabetes Association, blood pressure should be maintained lower than 130/80 millimetres of mercury (mm Hg) in people with diabetic nephropathy. If your blood pressure rises to more than 130/80 millimetres of mercury (mm Hg), you will be given medicines that lower blood pressure and protect the kidneys. Some of these medicines may not only lower the blood pressure but also reverse kidney damage when started as soon as any amount of protein is found in the urine (microalbuminuria). The ACE inhibitors and ARBs are blood pressure lowering medicines that may reverse the kidney damage in the initial stages of the disease (when there is very small amount of protein in your urine). Some experts recommend the use of these medicines before nephropathy (before microalbuminuria starts) occurs as they may help prevent nephropathy in people who have normal blood pressure. Many people with hypertension may need two or more medicines to lower the blood pressure enough to protect the kidneys. Your doctor will start one medicine and then add one at a time as needed.
- Avoid drugs that can injure the kidney: People with diabetic nephropathy should avoid medicines that can damage or stress the kidneys, especially non steroidal anti-inflammatory drugs (NSAIDs). Inform your doctor about all the medications that you take (prescription and non-prescription). Your doctor can tell you more about medications that may harm your kidneys.
- Maintain blood sugar: Control of blood sugar within your target range is important to prevent damage to the kidneys. Your doctor can recommend your target blood sugar, medications needed to control blood sugar and follow-up schedule to monitor your blood sugar.
- Diet plan: Low salt diet can help control high blood pressure more effectively (with or without medications). Diet that is low in protein can help you preserve kidney function in people with diabetic nephropathy. Your doctor or dietician can advise you regarding the amount of protein that is best for you.
These are some important aspects in the management of people with diabetic nephropathy. Your doctor can recommend the care and medications that are needed to protect your kidney if you have diabetic nephropathy.
Read more articles on Diabetic Nephropathy Treatment