NEPHROPATHY
Nephropathy is a progressive chronic loss of the kidney function that may occur in people with diabetes mellitus.
- It is also known as diabetic kidney disease.
- This condition affects the ability of the kidneys to carry out their normal function of removing waste products and extra fluids from the body.
- People with either type 1 or type 2 diabetes can be affected by the condition.
- Up to 40% of people with diabetes eventually develop kidney disease.
- It is a progressive condition that slowly damages the kidney’s filtering system.
- If treated early, the progression may be slowed down and chances of complications can greatly be reduced.
- It is a significant cause of long-term kidney disease. The kidney disease may progress to end-stage renal disease (ESRD) which is the last stage of nephropathy.
- ESRD is also called kidney failure, it is a condition in which the kidneys no longer work well enough to meet the needs of daily life and.
- Kidney failure is a life-threatening condition.
CAUSES
There are normally about 1.5 million nephrons in each adult kidneys. Nephrons are small structures that filter wastes from the blood. The nephrons can thicken and scar as a result of diabetes and this can make them unable to filter waste and remove fluid from the body. Material that would be typically be removed from the blood, such as protein, passes into the urine. Much of such protein is albumin (a protein made by the liver). The condition worsens as the albumin level increases.
Doctors believe that the condition is more likely to develop in people with high blood sugar levels (diabetes) and high blood pressure. The high blood sugar level associated with untreated diabetes causes high blood pressure and this can damage the kidney by increasing the pressure in the filtering system of the kidneys.
Other risk factors for the condition may include:
- Smoking
- A family history of kidney disease
- Obesity
SYMPTOMS
- Increased need to urinate
- Loss of appetite
- Fatigue
- Nausea and vomiting
- Darker urine
- Itching and dry skin
- Swelling of the arms, legs, eye, and ankles.
- Shortness of breath
DIAGNOSIS AND TREATMENT
To determine if you have the condition, the certain test may be performed, such as:
Blood tests to monitor your diabetes and determine how well your kidneys are working
Urine tests, this may provide information about your kidney function and check the level of protein in the urine. High level of protein may be indicative of kidney disease
Renal analysis testing, which can be used to test renal function and to assess your kidneys filtering capacity.
Imaging scans such as X-rays and ultrasounds to assess kidney structure and size. CT scan and MRI can also be used to check how well the blood is circulating within your kidneys.
A kidney biopsy may also be carried out.
TREATMENT
The first step of treatment is treating diabetes and your high blood pressure. Early treatment can delay complications.
Treatment options may include medications such as ACE inhibitors, Angiotensin II receptor blockers (ARBs) to treat high blood pressure.
A regular monitor of your blood sugar levels, using a proper dosage of insulin and taking medication prescribed by doctors can help to keep blood level sugars under control.
If your condition progresses to kidney failure or ESRD, kidney dialysis, transplant may help your condition.