Diabetic kidney disease (DKD) is a complex disease with multiple phenotypes. Approximately a third of diabetic patients develop diabetic kidney disease. Though there is a strong genetic basis for diabetic kidney disease, it is evident that both modifiable and unmodifiable environmental factors also play an important role. Kidney damage from diabetes typically occurs at about 5 years after the onset of Type 1 diabetes but can be present at the time of detection of Type 2 Diabetes. You can safeguard your kidneys and take measures to delay kidney damage. Morbidity and mortality are lower when diabetic kidney disease (DKD) is detected and treated early. Read ahead as Dr. Sashi Kiran A, Consultant Nephrologist, Yashoda Hospitals, Hyderabad shares everything related to diabetic kidney disease.
How diabetes can cause kidney diseases?
Your kidney's blood vessels might suffer damage from high blood glucose, often known as blood sugar. Blood vessels that have been damaged perform less effectively. High blood pressure is frequently a side effect of diabetes, and it can harm your kidneys. The combination of high blood sugars and high blood pressure releases a lot of mediators which would damage the kidney.
What raises the risk of diabetic kidney disease?
Kidney damage is more likely to occur if you have diabetes for a longer period of time. You have a higher risk of developing diabetic kidney disease if you have:
- Uncontrolled blood glucose
- Uncontrolled blood pressure
- Additional risk factors to develop diabetic kidney disease are:
- Age, increasing age is directly related to increased prevalence
- Ethnicity, more common in africans and Asians
- Sex, more common in women
- don't adhere to your diabetes diet
- consume salty foods,
- have heart disease
- have a family history of renal failure
Symptoms of diabetic kidney disease
DKD doesn’t cause symptoms until 80% of kidney function is lost. Symptoms would appear in the form of swelling of feet and puffiness of face. Evaluation at this time will reveal a leak of albumin in urine.
If there is a further delay in evaluation and treatment the symptoms may worsen. The additional symptomatology would include easy fatigability, increased urination at nights, loss of appetite and a breathlessness on exertion. Evaluation at this time would reveal an increase in serum creatinine and anaemia.
How to prevent diabetes and kidney disease?
- Early evaluation in persons with risk factors
- Avoiding sedentary lifestyle
- Reduce refined carbohydrates
- Tight control of blood sugars with appropriate medicines which should preferably include SGLT2 inhibitors.
- Tight control of blood pressure with appropriate medicines which should include an Angiotensin convertase (ACE) inhibitor or an Angiotensin receptor blocker (ARB).
- Establish or maintain a healthy lifestyle
You can achieve your blood pressure and blood glucose targets by adopting a healthy lifestyle. Additionally, the following recommendations will help you keep your kidneys in good condition.
- Give up smoking
- Develop a diabetes meal plan with a dietician and keep salt and sodium intake to a minimum.
- Include exercise in your daily regimen.
- Get to a healthy weight or maintain it.
- Get adequate rest. Every night, get 7 to 8 hours of sleep.
How to maintain the health of kidneys?
Try to meet your blood glucose and blood pressure targets as these are the greatest ways to reduce or avoid diabetes-related kidney damage. You can accomplish these goals and enhance your general health by adopting healthy lifestyle practices and taking your medications as directed.
Does kidney damage caused by diabetes worsen over time?
Diabetes-related kidney damage might deteriorate over time. Once the kidney function has deteriorated significantly, such that its function is only about 10% of the normal, the patient would be needing dialysis or kidney transplant. Fortunately, this can be avoided or delayed by maintaining a healthy lifestyle and with appropriate control of blood pressure and control of blood sugars.
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