Kidney Disease in Diabetes: How to Lower Your Risk of Nephropathy
The decline of the kidneys is referred to as necropathy. You may have heard about the later stages of the disease.
People with diabetes are at a
When left unaddressed, this diabetes complication can cause high blood pressure and cardiovascular disease, and lead to fatal organ failure, in contrast to the more common cases of diabetes.
It is important for people with diabetes to understand how to monitor and maintain their health.
As many as 40 percent of people with type 2 diabetes (T2D) and 30 percent of people with type 1 diabetes (T1D) are at risk of developing kidney disease. Middle-aged African Americans, Native Americans, and Hispanics are diagnosed with diabetic kidney disease at higher rates than the general population with diabetes.
The waste from the blood and urine is sent to the kidneys. They help regulate the amount of minerals in the body. They make hormones that regulate blood pressure, red blood cells, and bones.
Blood vessels in the kidneys can be damaged by elevated blood sugar levels. This damage is diagnosed as a disease called a kidneys disease.
“If not addressed, this damage can lead to the failure of the kidneys, which can cause waste to be thrown away. When this happens, the work that a person’s kidneys used to do needs to be replaced, either with regular dialysis sessions or a transplant.”
At its worst, nephropathy can lead to end stage renal disease (ESRD), an ultimately fatal organ failure.
When caught early in its progression, nephropathy can be stopped and reversed.
“The intervention’s effectiveness is dependent on a number of factors.”
- Keeping your blood sugar levels within a range.
- It is important to manage your blood pressure so that it is within a target range.
- Common anti-inflammatories and painkillers are known to affect the kidneys, so carefully monitoring use of over-the-counter medicines is important.
- A diet that restricts the amount of food.
- Keeping your cholesterol levels in check.
- Getting regular physical activity.
- Not smoking.
- limiting the amount of alcohol consumed
- Managing stress in healthy ways.
The most effective way to preserve your health is to keep your blood pressure andglucose under control. Keeping both of these within target range may help support healthy kidneys and reduce the likelihood of diabetes or hypertension.
Some medications may be beneficial in managing the health of the kidneys. These include:
- SGLT2 inhibitors and GLP1 receptor agonists, which provide some protection to the kidneys while bringing glucose levels down.
Finerenone , a nonsteroidal mineralocorticoid receptor antagonist, slows progression for people who unable to use SGLT2 inhibitors or who are at higher risk of developing kidney disease or cardiovascular issues.- ACE (angiotensin-converting enzyme) inhibitors or
ARBs (angiotensin receptor blockers) reduce blood pressure levels. - Diuretics remove extra fluid from the body.
- Cholesterol-lowering drugs help with cardiovascular health.
“Early on, nephropathy doesn’t show any symptoms.”
The symptoms that might show up are listed.
- Retaining fluid is a topic of discussion.
- upset stomach
- The appetite has been lost.
“The above symptoms don’t point to a specific issue with the kidneys.”
A combination of urine and blood tests are used to monitor kidney health and diagnose diabetes-related kidney disease.
Urine samples and microalbuminuria
“A urine sample is taken and checked for signs of the human body’s waste product.”
One of those proteins is albumin, which is made in the liver and normally found in your blood plasma. When albumin appears in the urine it is called
Microalbuminuria is also considered a risk marker for cardiovascular disease along with early kidney disease. Often, your doctor will order a microalbuminuria test if they believe you might be at risk for kidney damage or disease.
eGFR measurement of kidney function
From a blood sample an estimated glomerular filtration rate (eGFR) is calculated.
Creatinine, a normal waste product from muscle use, is measured. Based on blood creatinine levels, age, body size, and gender, a calculation is made to determine the person’s eGFR. The eGFR provides one measure of kidney function. For those who are experiencing kidney issues, it also identifies which stage of kidney disease the person is in.
There is some
African Americans are affected by the way creatinine is measured. The readings established for patients who identify as African American assume a higher muscle mass than other people taking the test, regardless of their actual body build. African Americans tend to have poorer outcomes when they are diagnosed with a disease like kidney disease.
The National Institutes of Health (NIH), National Kidney Foundation, and American Society of Nephrology have all called for change in the way eGFR is calculated, to eliminate this inherent racial bias.
Annual kidney screening for people with diabetes
The American Diabetes Association’s 2022 Standards of Care recommend annual kidney health screenings for all people with T2D and for those with T1D beginning 5 years after diagnosis.
People with a diagnosis of kidney disease may need to complete more screenings.
Phases of diabetes-related kidney diease
The progression of diabetes-related nephropathy is mapped out over five stages, each defined by its corresponding eGFR level. In general, the higher the better.
Stage 1: No symptoms. Defined as having a normal eGFR (90+).
Stage 2: No specific symptoms. Defined as having a mild decrease in kidney function and an eGFR between 60 and 89.
Stage 3: Symptoms like puffiness, water retention, or brown urine may start to appear. This stage of kidney function is characterized as having a moderate decrease and an eGFR between 30 and 59.
Stage 4: Symptoms show up more acutely now. There is a severe reduction of kidney function and an eGFR between 15 and 29.
Stage 5: This is kidney failure. The eGFR is less than 15. At this stage, dialysis or kidney transplant is needed.
It is possible to manage yourKidney health along with some medication throughout stages 1 through 4.
Stage 5 of the kidneys is when it becomes useless and more drastic treatment is needed.
Kidney dialysis for nephropathy
Dialysis requires spending 4 or more hours several days a week actively receiving treatment.
Sitting quietly while connected to a machine that filters the blood is what happens when you getrenalin.
Transplants for this diabetes-related complication
Kidney transplant requires major surgery along with extensive pre- and post-operative care. It can be difficult to find a compatible organ donor and can be very expensive. The average kidney transplant cost in 2020, according to this report, was $442,500.
One of the more serious and life threatening consequences of diabetes is phetopathy. Diabetes-related kidney disease is not inevitable.
Managing your kidneys through a combination of healthy habits, monitoring, and medication is the best way to keep your kidneys functioning well and avoid a transplant.
