1. Diabetes and Kidney Disease
Diabetes and Kidney Disease: Keep Your Kidneys Healthy
This article takes a look at kidney problems caused by diabetes. It is part of a series in which
you can learn the things that you can do each day and during each year to stay healthy and
prevent diabetes kidney failure.
What do my kidneys do?
When our body metabolizes proteins, it produces “nitrogenous” wastses, which need to be
filtered from the blood. The kidneys
are organs that act as filters to remove nitrogenous waste from the blood. They get rid of wastes
and return filtered fluid to the body. The micro filters in the kidneys are called glomeruli. When
kidneys are healthy, the arteries bring blood and wastes from the bloodstream into the kidneys.
The glomeruli clean the blood. Then wastes and extra fluid go out via the urine. Cleansed blood
leaves the kidneys and goes back into the bloodstream through the veins.
How can I prevent diabetes kidney problems?
All of the potential secondary problems that arise with diabetes are related to the
adverese affects of blood glucose levels‘ being out of the normal range. So the first basic
caution is to be vigilant in monitoring your blood glucose levels and : Keep your blood glucose
as close to normal as you can. If uncertain, ask your doctor what blood glucose levels are
healthy for you. Blood pressure comes up as a key concern for diabetes suffers. The kidneys
contain a bank of micro filters, and like any other filter they are stressed if a fluid medium is
pushed through them under too much pressure.
So, the next area to watch is your blood pressure:
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2. Keep your blood pressure below 130/80 to help prevent kidney damage. Blood pressure is
written with two numbers separated by a slash. For example, 120/70 is said as “120 over 70.”
Again, ask your doctor what blood pressure range is best for you. If you take blood pressure
pills daily, take them as your doctor directs – it’s important no to miss them. Keeping
your blood pressure under control will also slow down or prevent damage to your eyes,
heart, and blood vessels.
Kidney Medications
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3. There are two basic kinds of kidney medications that will slow down kidney damage. The
two kinds are :
· ACE (angiotensin converting enzyme) inhibitor
· ARB (angiotensin receptor blocker)
Do ask your doctor if you should be taking these medications.
Our diet can be a factor affecting kidney disease and recovery. It is advisable to follow a healthy
eating plan that you work out with your doctor or dietitian. If you have kidney problems, your
dietitian may suggest you cut back on protein rich foods such as meat.
Regular testing of these secondary problems is always part of the management of diabetes. It is
advisable to have your kidneys checked at least once a year. This is done by a urine test for the
presence of small amounts of protein. This test
is called the microalbumin test. Your annual check-up should also include testing for blood
creatinine. The result of this test is
used to estimate your glomerular filtration rate (GFR). That tells you how those micro filters are
doing, and is a basic measure of kidney function. There may be other kidney tests your doctor
thinks you need.
If you suffer from chronic pain, then there is a caution about taking painkillers regularly. Drugs
like aspirin or acetaminophen can damage the kidneys. You’re probably advised to take a
single daily dose of aspirin to protect the heart; and that
should be safe. Taking acetaminophen for *occasional pain* should also be safe. But if you are
dealing with chronic pain,
such as arthritis, you’ll need to work with your doctor to find a pain management strategy that
doesn’t put your kidneys at risk.
Infections pose a raised risk so, do see your doctor right away if you develop any bladder or
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4. kidney infections. You should suspect an infection if you have these symptoms:
pain or burning when you urinate
a frequent urge to go to the bathroom
urine that looks cloudy or reddish
fever or a shaky feeling
pain in your back or on your side below the ribs
How can my doctor protect my kidneys during special x-ray tests?
X-ray tests using a contrast agent may pose a risk to your kidneys. If you need x rays, your
doctor may recommend taking in
extra water before and after the x rays to protect your kidneys. Or, if possible, your doctor may
order a test that does not use
a contrast agent.
How can diabetes hurt my kidneys?
When the kidneys are working well, the micro filters in your kidneys keep protein inside your
body. You need the protein to stay healthy. High blood glucose and high blood pressure
damage the kidneys’ filters. When this happens, the protein leaks out of the kidneys into the
urine. Damaged kidneys aren’t able to properly clean out wastes and extra fluid from the blood.
Wastes and fluid build up in your blood instead of leaving the body in urine. Kidney damage
begins long before you notice any symptoms. An early sign of kidney damage is when your
kidneys leak small amounts of a protein called albumin into the urine. But the only way to know
about this leakage is to have your urine tested. With more damage, the kidneys leak more and
more
protein. This problem is called proteinuria. More and more wastes build up in the blood.
This damage gets worse until the kidneys fail.
Diabetic nephropathy is the medical term for kidney problems caused by diabetes. Nephropathy
affects both kidneys at the same time.
What can I do if I have kidneys problems caused by diabetes?
Once you have kidney damage, you cannot undo it. But you can slow it down or stop it from
getting worse by controlling your blood pressure, taking your ACE inhibitors or ARBs,
and having your kidney function tested regularly. However, if you are pregnant, you should not
take ACE inhibitors or ARBs.
How will I know if my kidneys fail?
At first, you cannot tell. Kidney damage from diabetes happens so slowly that you may not feel
sick at all for many years. You will not feel sick even when your kidneys do only half the job of
normal kidneys. You may not feel any signs of kidney failure until your kidneys have almost
stopped working. However, getting your urine and blood checked every year can tell you how
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5. well your kidneys are working.
Once your kidneys fail, you may feel sick to your stomach and tired all the time. Your hands and
feet may swell from extra fluid in your body.
What happens if I get diabetes kidney failure?
One way to treat diabetes kidney failure is with dialysis. Dialysis is a treatment that does
some of the work your kidneys used to do. Two types of dialysis are available. You and your
doctor will decide what type will work best for you.
1. Hemodialysis.
In hemodialysis, your blood flows through a tube from your arm to a machine that filters out the
waste products and extra fluid. The clean blood flows back to your arm.2. Peritoneal dialysis.In
peritoneal dialysis, your belly is filled with a special fluid. The fluid collects waste products and
extra water from your blood. Then the fluid is drained from your belly and thrown away.Another
way to treat diabetes kidney failure is to have a kidney transplant. The kidney can be from a
close family member, a friend, or someone you do not know. Many people are waiting for a new
kidney, so you may be on dialysis for quite a while. It may take time to find a donor with a good
match for your tissue type.What are the symptoms, if I start to have kidney problems?When
kidney problems arise, you won’t necessarily have symptoms. The first that know you have
kidney problems may be
when your doctor checks your blood for creatinine and your urine for protein. It’s pretty
clear that you should not wait for signs of kidney damage to appear; and that it’s best to
have your blood and urine checked.How do they test for kidney failure or problems?There’s
two basic lab tests can tell you and your doctor how well your kidneys are working; and these
should be done as part of your anual check-up. Each year, make sure your doctor orders tests
on a sample of your urine to see if your kidneys
are leaking small amounts of protein called microalbumin.
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6. Each year, your doctor should test your blood to measure the amount of creatinine.
Creatinine is one of the waste products your body makes.The kidneys filter out these wastes
from the blood. If your kidney
function is not working properly, these wastes can build up and make you sick. One of
the measures of kidney health is the
Glomerular Filtration Rate – the rate at which your kidneys are able to process blood and filter
out the wastes. Your doctor
can use your creatinine level to check your GFR.
Summary
A program of diabetes care goes well beyond monitoring blood glucose levels. Diabetes and
kidney disease are conditions that may occur together. Symptoms of kidneys problems don’t
necessarily show you when kidney failure is beginning. It’s important to have blood and urine
tests done annually to pick up first signs of kidney disease. There are a couple of
medications (ACE & ARB) that will slow down kidney damage. There are treatments for more
serious kidney failure. Keeping
blood glucose levels regular is one of the best ways to protect your kidneys from
secondary damage due to diabetes.
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