Nephropathy is the complication of individuals with diabetes when the kidneys are unable to function effectively as the result of progressive damage to the filter system. The only method of prevention is to ensure maintenance of healthy lifestyle habits and by regulating the blood pressure. It is estimated that around 40% of individuals with diabetes will continue to develop diabetic nephropathies. The advanced stage of this condition is known as end-stage renal disease. Individuals with either the type 1 or type 2 diabetes can develop diabetic nephropathy. This condition is divided into 5 stages and it can take an individual over 20 years to reach the final end-stage renal disease.
Causes
The kidneys are responsible for filtering the waste from the blood. This is performed by the kidney’s filter system (glomeruli) which consists of millions of tiny blood vessels. When these blood vessels become damaged, it can result in diabetic nephropathy and kidney failure in the later stage. Individuals with untreated diabetes have high blood sugar which can cause high blood pressure. This can also damage the delicate filter system of the kidneys.
Symptoms
Generally, the symptoms become evident only when the condition has progressed to an advanced stage. Typical symptoms associated with advanced stage of this disease includes swelling of the ankles, feet, hands and lower legs as the result of fluid retention, darker urine, fatigue from lack of oxygen, protein in the urine, loss of appetite and nausea or vomiting. In order to prevent the complications, individuals with diabetes are usually required for screening of the kidneys annually which includes a urine analysis to determine the presence of protein.
Diagnosis
When symptoms caused by the diabetic nephropathy are confirmed, the affected individual may be referred to a nephrologist or an endocrinologist. In order to determine the condition, diagnostic tests will be conducted that can include blood tests, urine tests, renal function test and various imaging tests. The blood tests can determine the function of the kidneys and the urine test can evaluate the presence of protein where high levels are indicative of affected kidney function. The imaging tests such as ultrasound can assess the structure of the kidneys and the renal function testing can determine the kidney’s filtering capacity.
Treatment
The treatment is usually based on the individual’s overall health, their age, past medical history, the extent of the disease and the preferred medical procedures. Generally, this condition can be treated when identified early with the detection of the small amount of protein in the urine. The early form of this disease can be controlled by monitoring the blood glucose, avoiding alcohol, consuming a healthy diet and with regular exercise. Medications can be used to lower the high blood pressure, reducing high cholesterol and to control the protein in the urine which can all assist in delaying and to prevent the kidney dysfunction. The advanced form of this disease may require kidney dialysis to remove the waste substances from the blood and kidney transplant is optional if the individual is an eligible candidate.
References
http://www.diabetes.co.uk/diabetes-complications/kidney-disease.html
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/diabetic-nephropathy/
https://www.diabetes.org.uk/kidneys
