Diabetic nephropathy is the name given to kidney disorders that occur in people with diabetes when their blood glucose control and other associated factors have not been adequate. It is part of the chronic complications of diabetes mellitus.
Diabetic nephropathy is responsible for about 30% of patients on regular dialysis and the first cause of kidney transplantation in Western countries.
When diabetic nephropathy occurs, it is virtually irreversible. It is therefore very important to detect it early and prevent its progression when diagnosed.
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What are the symptoms of diabetic nephropathy?
Diabetic nephropathy is completely asymptomatic until serious and often irreparable damage occurs in kidney function (kidney failure).
This requires regular blood and urine tests (at least once a year in people with type 2 diabetes) to detect early unsuitable protein loss in urine (albuminuria) and alterations in kidney function.
The most common symptoms are:
Decreased amount of urine.
Are you diagnosed with diabetes?
Remember that it’s important to keep a regular track of your kidney function
What causes diabetic nephropathy?
Factors that promote renal involvement:
Time to develop diabetes. Nephropathy occurs in 50% of patients after 20 years of the onset of diabetes.
High blood pressure. The presence of high blood pressure is the most important risk factor in diabetics for the development of nephropathy.
Glycosylated Hb. There is a relationship between the degree of blood glucose control measured by the percentage of glycosylated hemoglobin and micro vascular lesions. Intensive blood glucose control also slows the development of glomerulosclerosis.
What is the prognosis of diabetic nephropathy?
The application of pharmacological measures and of all kinds that in recent years have improved the control of diabetes and high blood pressure, is effective in preventing or slowing the progression of diabetic nephropathy.
In cases of renal failure progress has occurred mainly in renal transplantation, which currently allows many patients many years of independence from dialysis systems with lower rejection rate thanks to new immunosuppressive drugs.
How is diabetic nephropathy diagnosed?
An initial diagnosis of diabetic nephropathy requires a urine test to determine the amount of albumin removed in 24 hours and analysis of blood kidney function parameters. The presence of microalbuminuria is a sign of incipient nephropathy and is used as screening for early detection of renal involvement.
Diabetic nephropathy can be said to be virtually irreversible. It is therefore very important to detect it early and prevent its progression when diagnosed.
Strict blood glucose control and pharmacological treatment of high blood pressure have managed to slow or delay developments to more advanced states of the disease.
How is diabetic nephropathy treated?
Early treatment of diabetes nephropathy is the best way to slow developments
Certain types of antihypertensive drugs called angiotensin-converting enzyme inhibitors(IECAs)are especiallyeffective.
It is also very important to monitor lipid levels, maintain a healthy weight and engage in regular physical activity.
In cases of established diabetic nephropathy it is advisable to reduce the amount of protein in the diet following a specific eating plan.
Dialysis may need to be used once end-stage kidney disease develops. At this stage, consideration should be given to a kidney transplant.