Understanding
Diabetic Nephropathy
Diabetic nephropathy - kidney disease that results from diabetes - is the number one
cause of kidney failure. Almost a third of people with diabetes develop
diabetic nephropathy.
Kidney disease in type 1 diabetes is slightly different than in type 2 diabetes. In type 1 disease, kidney disease begins acutely and may start at an early or young age. Overt disease, when present, is obvious after about 15 years of having type 1 diabetes.
In type 2 diabetes, many patients have kidney disease at the onset, when they are diagnosed with diabetes. Because type 2 diabetes is frequently found in the middle or older aged person with other chronic medical conditions, kidney disease may have been caused by other conditions.
Symptoms of Diabetic Nephropathy
Although there are often no symptoms with early kidney damage, they may include:
Diagnosis
Diabetic nephropathy is detected by finding protein in the urine. That's why you should have your urine tested every year.
Treatment
If not treated, the kidneys will continue to fail and larger amounts of proteins can be detected in the urine. Advanced kidney failure requires treatment with dialysis or a kidney transplant.
People with diabetes and kidney disease do worse overall than
people with kidney disease, alone. This is because people with diabetes tend to
have other long-standing medical conditions, like high blood pressure, high
cholesterol and blood vessel disease (atherosclerosis). People with diabetes
also tend to have other kidney-related problems, such as bladder infections,
and nerve damage to the bladder.
Kidney disease in type 1 diabetes is slightly different than in type 2 diabetes. In type 1 disease, kidney disease begins acutely and may start at an early or young age. Overt disease, when present, is obvious after about 15 years of having type 1 diabetes.
In type 2 diabetes, many patients have kidney disease at the onset, when they are diagnosed with diabetes. Because type 2 diabetes is frequently found in the middle or older aged person with other chronic medical conditions, kidney disease may have been caused by other conditions.
Symptoms of Diabetic Nephropathy
Although there are often no symptoms with early kidney damage, they may include:
- Swelling
of the hands, feet and face.
- Weight
gain.
- Itching
(end-stage kidney disease) and extremely dry skin.
- Drowsiness
(end-stage kidney disease).
- Blood in
the urine (rare).
- Abnormalities
in the hearts' regular rhythm, because of increased potassium in the
blood.
- Muscle
twitching.
As kidney damage progresses, your kidneys cannot remove the waste
from your blood. The waste then builds up in your body and can reach poisonous
levels, a condition known as uremia. People with uremia are often confused or
comatose. Uremia is worsened by high blood pressure.
Diagnosis
Diabetic nephropathy is detected by finding protein in the urine. That's why you should have your urine tested every year.
Treatment
Lowering blood pressure and maintaining blood glucose control are
absolutely necessary to slow the progression of diabetic nephropathy. Some
medicines called angiotensin converting enzyme (ACE) inhibitors can help slow
down the progression of kidney damage. Although ACE inhibitors - including
Altace, Lotensin and Capoten - are usually used to treat high blood pressure
and other medical problems, they are often given to people with diabetes to
prevent complications, even if their blood pressure is normal. If a person has
side effects from taking ACE inhibitors, another class of drugs called
angiotensin receptor blockers can be given instead.
If not treated, the kidneys will continue to fail and larger amounts of proteins can be detected in the urine. Advanced kidney failure requires treatment with dialysis or a kidney transplant.
