This article takes a look at kidney problems caused by diabetes. It is part of a series in which you can learn the things that you can do each day and during each year to stay healthy and prevent diabetes problems.
What do my kidneys do?
When our body produces "nitrogenous" wastes when it metabolizes proteins; and these need to be filtered from the blood. The kidneys function as the filters that remove nitrogenous waste from the blood. As filters, they extract the wastes and return clean filtered fluid to the body. The kidneys are largely made up of micro filters called glomeruli. When kidneys are healthy, the arteries bring blood and wastes from the body into the kidneys, the glomeruli clean the blood, and the wastes and extra fluid go out via the urine. Filtered and cleansed blood leaves the kidneys and returns into the bloodstream through the veins.
How can I prevent diabetes kidney problems?
All of the potential secondary problems that arise with diabetes are due damage caused when blood glucose levels are outside of the normal range. This is why it's important to be vigilant in monitoring your blood glucose levels and keeping them close to normal as you can. If uncertain, ask your doctor what blood glucose levels are healthy for you.
In the article on heart and blood vessels, we noted blood pressure as a key concern for diabetes sufferers. The kidney is basically a bank of micro filters; and like any other filter they are damaged if a fluid medium is squeezed through them under too much pressure. So, the next area to watch, to avoid kidney problems, is your blood pressure. The aim is to keep your blood pressure below 130/80; and this will to help prevent kidney damage. Again, ask your doctor what blood pressure range is best for you. If you are on regular blood pressure pills, take them as your doctor directs - it's important no to miss them. Other body parts or functions that will benefit from keeping your blood pressure under control are your eyes, heart, and blood vessels.
There are two principal kinds of kidney medications that will slow down kidney damage. These are:
· ACE (angiotensin converting enzyme) inhibitor
· ARB (angiotensin receptor blocker)
Do ask your doctor if you should be taking these medications.
Diet can be a factor affecting kidney disease and recovery. Your doctor or dietician will ba bale to help you work out a healthy eating plan. If you have kidney problems, they may suggest you cut back on protein rich foods such as meat.
Regular Check-ups.
Regular testing of these secondary health issues is always part of the management of diabetes. You should have your kidneys checked at least once a year. There is a urine test for the presence of small amounts of protein. This test is called the microalbumin test. There is a blood test for the presence of creatinine. The blood test is used to check your glomerular filtration rate (GFR). It tells you how those micro filters are performing, and is a basic measure of kidney function.
If you suffer from chronic pain, then you should be careful about taking painkillers regularly. Medications like aspirin or acetaminophen can damage the kidneys. You've probably been advised to take a daily dose of aspirin to protect the heart; and that amount should be safe. Taking acetaminophen for *occasional pain* should also be safe. But if you have chronic pain, such as arthritis, you'll need to work with your doctor to find a pain management strategy that doesn't put your kidneys at risk.
Urinary infections that occur from time to time pose a raised risk with diabetes, so do see your doctor right away if you develop any bladder or kidney infections. You should suspect an infection if you have these symptoms:
· pain or burning when you urinate
· a frequent urge to go to the bathroom
· urine that looks cloudy or reddish
· fever or a shaky feeling
· pain in your back or on your side below the ribs
How can I protect my kidneys during special x-ray tests?
X-ray tests that use a contrast agent may pose a risk to your kidneys. If you need to have x ray examinations, your doctor may recommend taking in extra water before and after the x rays to protect your kidneys. Or, if possible, your doctor may order a test that does not use a contrast agent.
How can diabetes hurt my kidneys?
When the kidneys are healthy, the micro filters in your kidneys keep protein inside your body. High blood glucose and high blood pressure damage the kidneys' filters. When this happens, protein leaks out of the kidneys and into the urine. Damaged kidneys aren't able to filter out wastes and extra fluid from the blood. Wastes and fluid build up in your blood instead of leaving the body in urine. Kidney damage doesn't show symptoms early on. An early sign of kidney damage is when your kidneys leak small amounts of a protein called albumin into the urine; and this is why the annual urine test is recommended. As the kidneys become more damaged, they leak more and more protein.
This problem is called proteinuria. With this condition, more and more wastes build up in the blood. As the damage gets worse, the kidneys fail.
Diabetic nephropathy is the medical term for kidney problems caused by diabetes; and nephropathy affects both kidneys at the same time.
What can I do if I have kidneys problems caused by diabetes?
Once you have kidney damage, you cannot undo it; but you can slow it down or stop it from getting worse. This is achieved by controlling your blood pressure, taking your ACE inhibitors or ARBs, and having your kidney function monitored regularly. However, if you are pregnant, you should not take ACE inhibitors or ARBs.
How will I know if my kidneys fail?
Kidney damage from diabetes happens slowly, and you may not feel sickness for many years. You won't feel sick even when your kidneys do only half the job of normal kidneys!. You may not even feel any signs of kidney failure until your kidneys have almost stopped working. This is why it's so important to get your urine and blood checked every year. That way your doctor can tell you how well your kidneys are working. Signs of failure are feeling sick to your stomach and tired all the time. Your hands and feet may swell from extra fluid in your body.
What happens if I get diabetes kidney failure?
One way to treat diabetes kidney failure is with dialysis. Dialysis is a treatment that filters your blood the way your kidneys used to do. There's two types of dialysis are available. You and your doctor will decide what type will work best for you.
1. Haemodialysis.
In haemodialysis, your blood is taken through a tube from your arm to a dialysis machine that filters out the waste products and extra fluid. The clean blood flows back to your arm.
2. Peritoneal dialysis.
In peritoneal dialysis, your abdomen is filled with a special fluid. The fluid absorbs waste products and the extra water from your blood. The dialysis fluid is then drained from your belly and discarded.
Another way to treat diabetes kidney failure is to have a kidney transplant. The kidney can be from a close family member, perhaps from a friend, or even someone you do not know. It's all a matter of finding a good tissue match that your body will accept. Many people are waiting for a new kidney, so you may be on dialysis for
quite a while.
What are the symptoms, if I start to have kidney problems?
The first that know you have kidney problems may be when your doctor checks your blood for creatinine and your urine for protein. This should be done early in your diabetes management, and it's pretty clear that you should not wait for signs of kidney damage to appear.
Summary
A program of diabetes care goes well beyond monitoring blood glucose levels. Kidney disease is a conditions that may occur with diabetes; and kidneys problems don't necessarily show symptoms when kidney failure is beginning. It's important to have blood and urine tests done annually to pick up first signs of kidney disease. There are a couple of medications (ACE & ARB) that will slow down kidney damage and help you to manage a good health plan. There are treatments for more serious kidney failure. Keeping blood glucose levels regular is one of the best ways to protect your kidneys from secondary damage due to diabetes.
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