Diabetes is an illness triggered by lack of insulin in the body or the body’s inability to use normal quantities of insulin in accurate levels. It is the commonest cause of kidney disease. Insulin, manufactured by the pancreas, regulates the concentration of glucose in the blood. When the body lacks insulin, this haphazardly results in high blood sugar levels, eventually, leading to several unhealthy pathologies in body organs including the kidneys.
In this article, we will look at
1. How Does Diabetes Affect the Kidneys?
2. Signs and Symptoms of Diabetic Nephropathy
3. Diagnosis and Treatment of Diabetic Nephropathy
How Does Diabetes Affect the Kidneys
The major function of kidneys is to eliminate waste matter from the blood and return purified blood back to the body. Diabetic nephropathy is one of commonest complications of long-term diabetes, and this should be prevented as much as possible since it can easily result in renal failure.
Diabetes is the commonest cause of kidney disease and even if diabetes is controlled, already initiated pathology can result in chronic kidney disease and kidney failure.
According to latest data, 20-30% of people with diabetes are susceptible to get kidney disease, even though not all of them would develop into aforementioned renal failure. Furthermore, it is important to keep in mind that a person with diabetes is vulnerable to nephropathy regardless of the fact whether they use insulin or not.
The incidence of diabetic nephropathy is high in patients who have diabetes over a long period of time with other co-morbidities.
Process of Diabetic Nephropathy
When the blood sugar level in an individual is high for a long time, there will be 3 major histological changes taking place in the glomeruli of kidneys.
1. Increased production and uncontrolled glycation of matrix proteins, resulting in a rapid mesangial expansion (augmentation of the extracellular matrix)
2. Thickening of the glomerular membrane
3. Intra-glomerular hypertension due to dilatation or ischemic injury to the affected renal artery injury (due to hyaline thickening), causing glomerular sclerosis
All these changes have a similar prognostic value, and properly controlled Diabetes will prevent these irreversible changes from occurring.
Signs and Symptoms of Diabetic Nephropathy
Most signs and symptoms of this pathology are not accurate and noted only in the later stages.
- Ankle swelling which progresses into hands and body later.
- Generalized edema
- Sleep disturbances
- Loss of appetite and weight
- Gastrointestinal tract disturbances
- Poor concentration
What Can Be Done For Diabetic Neuropathy
Diabetic nephropathy can be diagnosed mainly with investigations such as,
Urine tests – Measure protein levels. An exceptional standard of protein in the urine is a major sign of diabetic nephropathy.
Blood pressure – Regular follow-ups for high blood pressure are necessary since an elevation of blood pressure is triggered by diabetic nephropathy which may subside spontaneously during the course of its progression.
Renal function test – Check the notch of kidney function.
Biopsy – A small tissue section is extracted from the kidney with the help of a thin needle and assessed in a laboratory. A biopsy is typically indicated in suspected patients with kidney damage and its possible etiology.
Kidney ultrasound – Kidneys are tested for signs and symptoms of reduced renal function.
There is no cure for diabetic nephropathy. It is also important to know that these various types of treatment used recklessly can become more antagonizing since there is a chance of a possible weakening of kidneys then leading to renal failure.
Therefore,
- Prevention is the most helpful method of therapy with a proper control of blood glucose levels and blood pressure.
- Dialysis or non-natural kidney treatment
This is usually to prevent patients reaching, End-stage kidney failure which is defined as the inability of the kidney to work at all.
This advanced mechanism known as Dialysis contains the filtration of patient’s blood over a distinctive machine which will eliminate waste materials over time while stabilizing water and electrolyte levels.
- Kidney transplantation
A kidney obtained from a compatible donor can be transplanted, and this is indicated as a special category of patients including young children, patients without any significant co-morbidities, etc.
Image Courtesy:
“Hemodialysis schematic” By National Institute of Diabetes and Digestive and Kidney Diseases – (Public Domain) via Commons Wikimedia
“Blausen 0310 Diabetic Nephropathy” By “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. – Own work (CC BY 3.0) via Commons Wikimedia
