How Does Diabetes Affect The Kidneys

Kidneys are the vital organs of the body, which help in the removal of the waste products, and balance body fluids. The kidneys also play a role in maintaining blood pressure, producing red blood cells, and strengthening the bones.

The damage to the kidneys could disrupt these functions leading to serious complications. The common causes of kidney damage include uncontrolled diabetes and hypertension.

Here is a brief discussion about how diabetes affects the kidneys and the treatment and prevention of kidneys disorders linked to diabetes.

What is diabetic nephropathy?

Diabetic nephropathy, also called diabetic kidney disease (DKD) or chronic kidney disease (CKD), is the term used to describe the renal dysfunctions linked to the high blood sugar levels in patients with diabetes.

It is estimated that more than 80% of the patients with kidney failure (end-stage renal disease) have pre-existing diabetes or hypertension or both.

This marks the importance of controlling the blood sugar levels in order to protect the kidneys and prevent the risk of diabetic nephropathy.

How does a high blood sugar level affect the kidneys?

The blood enters the kidney through a large artery and then, passes through the clusters of smaller blood vessels that are termed glomeruli. These glomeruli act as filters and help the kidneys to filter the unwanted, harmful or waste products from the blood along with other excess fluids. The filtered blood then goes back into the blood circulation through a vein to be carried to the heart and lungs where it is oxygenated. The excess fluid in the kidneys along with the waste products is excreted out of the body in the form of urine.

However, in the patients with diabetics,these simple processes of the filtration of blood and the excretion of urine are affected due to the following complications:

• The high blood sugar level caused due to diabetes makes the glomeruli narrower and clogged. This inhibits the flow of the blood through the blood vessels, thereby damaging the tissues of the kidney.

The damaged kidneys allow a type of protein called albumin to pass or leak into the urine leading to albuminuria, a symptom that marks the beginning of acute or chronic kidney disorders.

• Diabetes may also damage the nerves that carry signals between the brain and the kidneys and urinary bladder. The damaged nerves can prevent the person from feeling when the bladder is full. This puts excess pressure on the kidneys resulting in damage.

• When the urine remains in the bladder for a very long time, it elevates the risk of developing a urinary tract infection. The increase in the sugar level in the urine allows the infection-causing organisms to grow and multiply at a faster speed leading to urinary infections.

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What are the symptoms of kidney damage?

In the initial stages of the kidney diseases, the patients with diabetes may not have any visible symptoms. Hence, it is important to undergo the renal function tests at least once every year so that thedecline in the renal functions could be detected at an earlier stage.

The doctors can ask patients for a simple urine test known as the ACR (albumin creatinine ratio) to detect the presence and the relative amount of proteins in the urine. The GFR (glomerular filtration rate) test may also be advised to determine the ability of the kidneys to filter the waste products.

In the later stages of kidney damage, the patient may experience:

• Swelling of the ankles, hands, and feet
• Frothy and bubbly urine due to the presence of proteins like albumin in it
• Nausea
• Blood in the urine
• Persistent fatigue
• Shortness of breath

Treatment of kidney damage linked to diabetes

ACE (angiotensin-converting enzyme) inhibitors

ACE inhibitors help by reducing the amount of angiotensin II, a chemical that tends to constrict the blood vessels. The less amount of this chemical in the body causes the blood vessels to widen and relax thus reducing the blood pressure.

ACE inhibitors might help to prevent or delay the progress of the kidney diseases.

AIIRA (angiotensin-II receptor antagonist)

AIIRAs have a similar mechanism of action like ACE inhibitors. Patients may use AIIRAs instead of ACE inhibitors if they have side-effects with an ACE inhibitor.

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What can be done to prevent the kidney damage linked to diabetes?

Monitor the blood sugar levels

Keeping your blood sugar level in a healthy range could help in protecting the kidney tissues from damage. Patients should check their blood sugar level regularly or get their HbA1c test done once in 3 months. This test gives an average blood sugar level over the last 3 months.

Adopt healthy eating habits

Diabetic patients should indulge in healthy dietary habits such as adding fruits, vegetables, lean proteins, and healthy fats to their diet to keep blood sugar levels within normal limits.

They should also reduce their consumption of highly refined or sugary foods such as crackers, cookies, and soda.

Limit alcohol and quit tobacco

Quit chewing tobacco and smoking as these could worsen the kidney damage. Patients should also reduce the intake of alcohol to avoid any damage to the kidneys.

Conclusion

Early diagnosis of diabetic nephropathy based on the symptoms and the routine tests could help to reduce the risk of renal failure to a great extent. Regular treatment of diabetes and adopting healthy dietary practices to maintain the blood sugar levels within the normal limit can play a key role in the prevention of diabetic nephropathy.

Medical professionals can learn more about the impact of diabetes on the kidney and the most effective ways to manage this condition by attending our Live Respiratory Disease & Care Webinar.