What Is Diabetic Nephropathy?

Diabetes nephropathy progresses slowly, therefore with early treatment the progression can be slowed further or even stopped. Having diabetes does not necessarily mean you will develop diabetic nephropathy, and those who do develop the condition, it may not always lead to kidney failure or ESRD.

Symptoms Of Diabetic Nephropathy

Symptoms of diabetic nephropathy may not be seen in the initial stages, but in the later stages, the patient may develop symptoms such as:

• Degrading blood pressure control
• Protein in the urine
• Swelling of the feet, ankles, hands or eyes
• Frequent urination
• Reduced need for insulin or diabetes medicine
• Difficulty concentrating
• Breathlessness
• Loss of appetite
• Nausea and vomiting
• Persistent itching
• Fatigue

How Is Diabetic Nephropathy Diagnosed?

If you suffer from diabetes, your doctor is most likely to perform yearly blood and urine tests to look for early signs of kidney damage. The common tests include:

• Microalbuminuria urine test: Presence of protein in the urine is a sign of kidney damage. Microalbuminuria urine test helps determine the presence of albumin a type of protein in the urine.
• BUN Blood Test: This test looks for the presence of urea nitrogen in the blood. Elevated levels of urea nitrogen may be an indication of kidney ailments.
• Serum Creatinine Blood Test: This test measures the levels of creatinine in the blood. Presence of creatinine indicates kidney damage as damaged kidneys cannot remove creatinine from the blood.
• Kidney Biopsy: When the doctor suspects diabetic nephropathy in a patient, they may perform a kidney biopsy. This is a surgical procedure in which a small sample of one or both the kidney(s) is taken and viewed under a microscope to look for damage.

Treatment

Although diabetic nephropathy is not completely curable, early detection and management can help slow the progression, which in turn increases the lifespan of the patient. Preventing the chances of the progression of the disease must be your first step, for which controlling your diabetes is crucial. 

Treatment For Advanced Diabetic Kidney Disease

If your diabetes leads to diabetic nephropathy which further progresses to end-stage kidney disease, the following treatment options may be advised by your doctor: 

• Kidney Dialysis: One of the most important functions of the kidney is to remove the waste products and extra fluid from your blood. When the kidneys don’t function well, the accumulation of these waste products in the blood may lead to various health ailment. Therefore, it becomes crucial to somehow get rid of all the toxins. Kidney dialysis is a process which helps in that. There are two main types of dialysis - hemodialysis and peritoneal dialysis.
  1. Hemodialysis is the most common type of dialysis in which you simply visit a dialysis centre and be connected to an artificial kidney machine about three times a week. Each session takes nearly three to five hours. 
  2. Peritoneal dialysis uses the peritoneum in the patient’s abdomen as the membrane through which fluids and other essential dissolved substances are exchanged with the blood. The procedure helps remove excess fluid, correct electrolyte problems, and remove toxins in those with kidney failure.
• Transplant: In cases where patients don’t respond well to dialysis or any other treatment procedure, a transplant may be suggested. A transplant is a surgical procedure in which the diseased kidneys are replaced with a healthy, functioning kidney(s) from a donor. 
• Symptom Management: Those who do not favour dialysis or transplant, their life expectancy would be only a few months. In these few months, you may receive treatments to help keep you comfortable. 

Lifestyle Changes And Home Remedies

Living a healthy lifestyle can help you support your treatment goal. Listed below are a few tips that you can follow to support your treatment:

• Be active most days of the week
• Plan a healthy diet.
• Limit the intake os sodium, potassium and protein
• Quitting smoking
• Maintaining a healthy weight

Dr G Sridhar

Chief Consultant – Nephrologist & Kidney Transplant Surgeon

Disclaimer:The views and opinions expressed in this article belong solely to the author. They do not reflect the opinions or views of the organization.