This is The Disease Caused by Diabetes (NEPHROPATHY)
Thursday, November 22, 2018
The longer a person suffers from diabetes, or the presence of other risk factors such as hypertension, the higher the risk of developing diabetic nephropathy as well.
Symptoms Of Diabetic Nephropathy.
In the early stages of its development, diabetic nephropathy is often showing no symptoms whatsoever.
But if the kidney damage continues, there will arise a number of symptoms, such as:
• Increased urination Frequency or vice versa.
• Itching.
• Lost appetite.
• Insomnia.
• Limp.
• Puffy eyes.
• Nausea and vomiting.
• Swelling of the arms and legs.
• Difficult to concentrate.
• There is protein in the urine and the urine foamy.
Causes Of Diabetic Nephropathy.
Diabetic nephropathy occurs when diabetes caused the damage and the formation of scar tissue on the front. Nefron is part of the kidney that functions to filter waste from the blood and dispose of excess fluid from the body.
In addition to the lead, the function is compromised, the damage also makes a protein called albumin lost to the urine and not reabsorbed.
Not yet known why the above conditions occur in diabetics, but allegedly associated with the high sugar levels and blood pressure, two conditions that can interfere with kidney function.
In addition to high blood sugar levels (hyperglycemia) and high blood pressure (hypertension) uncontrollable, other factors that can increase the risk of diabetic nephropathy is:
• Smoking.
• Suffer from type 1 diabetes before the age of 20 years.
• Suffer from high cholesterol.
• Having excess body weight.
• Have a history of diabetes and kidney disease in the family.
• Suffer from diabetes complications, such as diabetic neuropathy.
- Get to Know More About The Ins and Outs Of The Disease Diabetes Insipidus
- This is the result when high blood pressure is left untreated
The Diagnosis Of Diabetic Nephropathy
The doctor may suspect patients stricken with diabetic nephropathy when diabetics experience a number of symptoms that have been described previously. But for sure, the doctor may do a follow-up inspection to check kidney function, such as:
• Test the BUN (blood urea nitrogen) or rum. This test aims to measure the levels of urea nitrogen in the blood. Urea nitrogen residual substance metabolism is normally filtered out by the kidneys and disposed of along with urine. A normal BUN levels depend on age and gender, i.e., 8-24 mg/dL in men mature, 6-21 mg/dL in women adult, and 7-20 mg/dL in children ages 1-17 years.
• Test creatinin. This test is done to measure the levels of creatinine in the blood. Same as nitrogen urea, creatinine is also a waste the rest of metabolism, which is normally discarded along with urine. Generally, normal in individuals ages creatinin 18-60 year ranges between 0.9-1.3 mg/dL for men, and 0.6-1.1 mg/dL for women.
• the test LFG (glomerulus filtration rate). The test LFG is a type of blood test done to measure kidney function. Lower values of LFG, the bad kidney function in filtering waste, as will be described below:
o Stage 1 (LFG 90 above): the kidneys function properly.
o Stage 2 (LFG 60-89): a mild disorder on renal function.
o Stage 3 (LFG 30-59): disorders of the kidney function of intermediate stages.
o Stage 4 (LFG 15-29): heavy interference on kidney function.
o Stage 5 (LFG 15 under): kidney failure.
• Urine Microalbuminuria Test. Patients suffering from diabetic nephropathy may be suspected when urine protein called albumin. The test can be done by taking urine samples of the patients randomized in the morning or accommodated for 24 hours.
The levels of albumin in the urine are still quite normal when under 30 mg. Whereas the levels of albumin in the range of 30-300 mg (Microalbuminuria), indicate the conditions of the early stages of kidney disease. When more than 300 mg (microalbuminuria), the condition indicates kidney disease who have been growing more severe.
• Imaging Tests. A doctor can perform an ULTRASOUND of the kidneys or x-rays, to see the structure and size of kidney patients. CT scan and MRI can also be conducted in order to assess the condition of the blood circulation in the kidney.
• Kidney Biopsy. When needed, the doctor may take a bit of kidney tissue samples from patients. The samples will be taken with a fine needle and examined using a microscope.
Treatment Of Diabetic Nephropathy.Diabetic nephropathy is not curable, but its development can be prevented to keep it from getting worse. The treatment is done aims to control blood sugar levels and high blood pressure. Treatment methods include administering medication, such as:
• Enzyme angiotensin inhibitor Drugs modifier (ACE Inhibitors) or ARBS (angiotensin II receptor blockers), to lower high blood pressure while holding the leaking of albumin into the urine.
• Cholesterol-lowering Drugs, such as statins, to treat high cholesterol, one of the risk factors of diabetic nephropathy.
• Insulin, to lower blood sugar levels.
In addition to administering medications, physicians will also recommend that patients undergo a stricter diet. Of which by limiting your intake of protein, reduce your intake of sodium or salt is less than 1500-2000 mg/dL, limit consumption of foods high in potassium such as bananas and avocados, as well as limiting consumption of foods high in phosphorus such as yogurt, milk, and processed meat.
When diabetic nephropathy patients undergoing the final stages of kidney failure, doctors can advise patients to undergo kidney replacement therapy. This procedure aims to cleanse the blood of wastes the rest of metabolism. Renal replacement therapy in the form of bias in the form of washing the blood using a machine (hemodialysis) 2-3 times a week, wash the blood through the stomach or peritoneal dialysis (CAPD), or kidney transplant.
Prevention Of Diabetic Nephropathy.
Diabetic nephropathy can be avoided by fixing lifestyle through simple measures, such as:
• Handle diabetes properly. Handling right diabetes can delay or even prevent diabetic nephropathy.
• Maintain blood pressure and health in General. Individuals with risk factors of diabetic nephropathy are advised to regularly visit a physician to be aware of the signs of kidney damage.
• Follow the instructions of use of the drug. Use the drugs properly, especially when the patient is diabetic nephropathy taking any medication pain reliever the nonsteroid anti-inflammatory drugs. The use of drugs that do not fit the clues can trigger kidney damage.
• Maintain an ideal weight. Do regular exercise a few days a week so that ideal body weight maintained. For patients with obesity, consult a doctor about how to lose weight.
• Quit smoking. Smoking can damage the kidneys and kidney conditions are aggravating the already damaged.
Complications Of Diabetic Nephropathy.
Diabetic nephropathy is the cause of most chronic kidney disease chronic kidney failure or end-stage in America and in the world. In Indonesia alone, 52 percent of patients who undergo washing blood from diabetic nephropathy.
Other complications due to diabetic nephropathy that can evolve gradually in a matter of months or years, among others:
• Open Wounds in the legs.
• Anemia or a lack of red blood cells.
• Increase the levels of potassium in the blood (hyperkalemia) suddenly.
• Fluid retention that can trigger swelling in the hands, feet, or in the lungs (pulmonary edema).
References :
Nazar, c. (2014). Diabetic Nephropathy; Principles of Diagnosis and Treatment of Diabetic Kidney Disease. Journal of Neuropharmacology, 3 (1), pp. 15-20.
Rezaii, h. Shahbazian, i. (2013). Diabetic Kidney Disease; A review of the Current Knowledge. Journal of Renal Injury Prevention, 2 (2), pp. 73-80.
Indonesian Renal Registry (2016). 9th Report of Indonesian Renal Registry.
NIH (2017). The National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic Kidney Diseases.
Mayo Clinic (2016). Diseases and Conditions. Diabetic Nephropathy.
Burke, d. Healthline (2018). Microalbuminuria Test.
Nall, r. Healthline (2016). Glomerular Filter Rate Test.
Nall, r. Gabbey, a. Healthline (2018). Blood Urea Nitrogen (BUN) Test.
Roth, e. Healthline (2017). Creatinine Blood Test.
Nazar, c. (2014). Diabetic Nephropathy; Principles of Diagnosis and Treatment of Diabetic Kidney Disease. Journal of Neuropharmacology, 3 (1), pp. 15-20.
Rezaii, h. Shahbazian, i. (2013). Diabetic Kidney Disease; A review of the Current Knowledge. Journal of Renal Injury Prevention, 2 (2), pp. 73-80.
Indonesian Renal Registry (2016). 9th Report of Indonesian Renal Registry.
NIH (2017). The National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic Kidney Diseases.
Mayo Clinic (2016). Diseases and Conditions. Diabetic Nephropathy.
Burke, d. Healthline (2018). Microalbuminuria Test.
Nall, r. Healthline (2016). Glomerular Filter Rate Test.
Nall, r. Gabbey, a. Healthline (2018). Blood Urea Nitrogen (BUN) Test.
Roth, e. Healthline (2017). Creatinine Blood Test.