Did you know that
diabetes affects the kidney? Diabetic nephropathy (diabetic kidney disease) is
one of the important specific complications of diabetes. Around 30 to 50
Uncontrolled high
blood sugar for long period of time produces functional and later structural
changes in the kidneys. But what is unfortunate is that the changes
occurring
in kidneys are not clinically obvious to the treating doctor. The symptom the
patient shows is until the kidney function is severely affected and the disease
has reached an irreversible stage.
One popular and
appropriate way of detecting early kidney damage in diabetes is through urine
test. Presence of albumin leak in urine is called albuminuria of proteinuria.
In routine urine
examination will detect albuminuria. However, as there are no symptoms this is
not given any clinical importance and often goes unnoticed without medical
care. Albumunuria is a symptom of early diabetic kidney disease. Aggressive
treatment should start at this time and the progression of the kidney damage
could be delayed or arrested.
Regular and
routine examination of urine will detect albumunura. However, there is another
sensitive test for detection of microabluminuria. This test detects minute
amounts of albumin leaked into the urine (microabluminuria).
Microabluminuria
is a sign of early abnormalities of the blood vessels (endothelial dysfunction)
and a forerunner of atherosclerosis (hardening of arteries). Therefore presence
of albuminuria is an indication to aggressive treatment of cardiovascular risk
factors.
So, could we delay
or prevent diabetic kidney disease with the available tools of medical
treatment. Most research studies have shown that adequate and long-term control
of blood sugar, blood pressure and nutritional changes can help in preventing
kidney disease. However, the efforts should start early in the life of people
with diabetes. New classes of drugs used for treatment of hypertension are
called angiotension-converting enzyme inhibitors. These agents were originally
invented and used for treatment of hypertension. But they were found to be
beneficial in preventing kidney disease in persons with diabetes, especially in
patients who have albuminuria.
Other than the
specific diabetes kidney disease, people with diabetes are also more prone to
urinary tract infections. Chronic recurrent urinary tract infection is more
common due to high blood sugar levels. Diabetes can also affect the nerves
supplying the urinary bladder and produce abnormal bladder function (diabetes
ystopathy). This can lead to deficient urinary evacuation and urinary
retention. Therefore prevention of infections also helps in preventing kidney
damage in diabetes.
So, remember, if
you are a diabetic then have urine examination for albumin periodically to
detect kidney disease.
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