Control Your Blood Pressure
Blood pressure is the force of your blood against the wall of your blood vessels. High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.
Your health care team will also work with you to help you set and reach your blood pressure goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask your health care team what your goal should be.
Medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and DKD. The names of these medicines end in pril or sartan. ACE inhibitors and ARBs are not safe for women who are pregnant.
Treatment For Diabetic Nephropathy
Early detection and treatment of diabetic nephropathy can not only stop the progression of kidney disease in people with diabetes, but during the early stages can actually reverse it. Treatment involves controlling both your blood glucose levels and your blood pressure.
Blood glucose levels should be kept in the normal range as much as possible to prevent or slow the progression of diabetic nephropathy. Lifestyle measures in combination with oral diabetes medicines or insulin can be used to control blood glucose levels.
People with type 2 diabetes who have microalbuminuria or proteinuria are usually also treated with medicines called angiotensin-converting enzyme inhibitors or angiotensin receptor blockers . These medicines are also used to control blood pressure, but even if your blood pressure is normal, your doctor may prescribe an ACE inhibitor or ARB because they decrease the amount of protein in the urine and can prevent or slow the progression of diabetic kidney disease.
Other medicines may also be prescribed to help control high blood pressure.
Symptoms Of Kidney Disease In Diabetics
Symptoms of kidney disease aren’t noticeable until you have chronic kidney disease, which leads to kidney failure. Diabetes is the most common cause of kidney failure, which accounts for nearly 44 percent of new cases and affects over 100,00 Americans every year. Nearly a third of people with diabetes will develop kidney disease, and you’re more likely to be in this group if you have type 1 diabetes as opposed to type 2 diabetes.
Your kidneys are essential for filtering toxins out of your body. When they’re damaged, waste products re-enter your blood, and essential nutrients get eliminated in your urine. Because the majority of people with diabetes don’t develop chronic kidney disease or kidney failure, we know it can be prevented.
Some people with diabetes may develop a sense of complacency if they don’t have any warning signs. But, symptoms of kidney disease aren’t noticeable right away they begin to happen after your kidneys have sustained a lot of damage, and may not be obvious.
One of the first symptoms of kidney disease is a small amount of protein in your urine, or microalbuminuria. While most people have microalbuminuria when they’re first diagnosed, it doesn’t mean that kidney disease is inevitable. Another early sign is edema–swelling or fluid buildup in the feet and hands, or around the eyes.
Other symptoms include:
- bad breath, or a bad taste in your mouth
- fatigue or weakness
- yellowish-brown color of the skin
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Diabetes Can Cause Kidney Failure: Know The Symptoms
Diabetes disturbs the sugar levels of the patient which affects the other parts of the body as well. It can affect the kidneys as well. Know the signs and symptoms one can experience due to diabetes.
Diabetes is a serious health condition which can become deadly in some cases. Is disturbs the sugar levels of the patient which affects the other parts of the body as well. The kidneys of a diabetic patient also get affected due to the increased levels of sugar in the blood. Untreated diabetes can lead to higher levels of sugar in the blood which can even lead to kidney failure. There are some signs and symptoms which a diabetic patient may experience when his or her kidneys get affected. These symptoms should not be ignored.
Chronic Kidney Disease Basics
Kidney disease means the kidneys cant filter blood and make urine as they should. Chronic kidney disease occurs slowly over many years and usually cant be reversed.
- Early kidney disease, sometimes called renal insufficiency You may have no signs or symptoms until the disease is advanced, but the damage is still being done. Blood tests to check kidney filtration rate and urine tests to check for protein in your urine are the only ways to find out if you have kidney disease at this stage. Its important to be tested for kidney disease if you have diabetes so it can be detected and treated early to slow progression of the damage. Keeping your blood sugar and blood pressure under control are very important to slow kidney disease. Losing weight, getting regular exercise and not smoking are great ways to help control blood sugar and blood pressure.
- Kidney failure, or end-stage renal disease Kidney failure means damage to the kidneys has progressed to the point that they are not doing a good job of filtering wastes such as urea and creatinine from the blood so it can be excreted in the urine. The waste buildup can make you sick. You may have these symptoms: swelling of the ankles or face, vomiting, loss of appetite, fatigue, confusion and headaches. Treatments for kidney failure may include: hemodialysis, peritoneal dialysis or a kidney transplant. Its important to work with your health care team to decide which treatment is best for you.
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Diabetes And Chronic Kidney Disease
If you have diabetes, ask your doctor about kidney disease.
Chronic kidney disease often develops slowly and with few symptoms. Many people dont realize they have CKD until its advanced and they need dialysis or a kidney transplant to survive.
If you have diabetes, get your kidneys checked regularly, which is done by your doctor with simple blood and urine tests. Regular testing is your best chance for identifying CKD early if you do develop it. Early treatment is most effective and can help prevent additional health problems.
CKD is common in people with diabetes. Approximately 1 in 3 adults with diabetes has CKD. Both type 1 and type 2 diabetes can cause kidney disease.
- Kidney diseases are the 9th leading cause of death in the United States.
- Approximately 1 in 3 adults with diabetes has CKD.
- Every 24 hours, 170 people with diabetes begin treatment for kidney failure.
What Are The Early Signs Of Kidney Disease In Patients With Diabetes
The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in your doctor’s office show evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.
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Upset Stomach Nausea Vomiting
Why this happens:
A severe build-up of wastes in the blood can also cause nausea and vomiting. Loss of appetite can lead to weight loss.
What patients said:
I had a lot of itching, and I was nauseated, throwing up all the time. I couldn’t keep anything down in my stomach.
When I got the nausea, I couldn’t eat and I had a hard time taking my blood pressure pills.
Stages Clinical Features And Clinical Course
Diabetic nephropathy has been didactically categorized into stages based on the values of urinary albumin excretion : microalbuminuria and macroalbuminuria. The cutoff values adopted by the American Diabetes Association for the diagnosis of micro- and macroalbuminuria, as well as the main clinical features of each stage, are depicted in . There is accumulating evidence suggesting that the risk for developing diabetic nephropathy and cardiovascular disease starts when UAE values are still within the normoalbuminuric range. Progression to micro- or macroalbuminuria was more frequent in patients with type 2 diabetes with baseline UAE above the median . After 10 years of follow-up, the risk of diabetic nephropathy was 29 times greater in patients with type 2 diabetes with UAE values > 10 g/min . The same was true for patients with type 1 diabetes . This favors the concept that the risk associated with UAE is a continuum, as is the case with blood pressure levels . Possibly, values of UAE lower than those currently used for microalbuminuria diagnosis should be established.
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Intensive Blood Glucose Control
Clinical trials have consistently demonstrated that A1c levels < 7% are associated with decreased risk for clinical and structural manifestations of diabetic nephropathy in type 1 and type 2 diabetic patients. In the Diabetes Control and Complications Trial , intensive treatment of diabetes reduced the incidence of microalbuminuria by 39% . It is interesting to note that patients randomized to strict glycemic control had a long-lasting reduction of 40% in the risk for development of microalbuminuria and hypertension 78 years after the end of the DCCT . In the UKPDS, a 30% risk reduction for the development of microalbuminuria was observed in the group intensively treated for hyperglycemia . Moreover, in the Kumamoto Study, intensive glycemic control also reduced the rate of development of micro- and macroalbuminuria . Therefore, intensive treatment of glycemia aiming at A1c < 7% should be pursued as early as possible to prevent the development of microalbuminuria.
More Information And Support About Kidney Disease
Talk with your diabetes team. They should be able to answer most of your questions. And were here to provide support and information when you need it too.
If you have more questions, or just want someone to listen, give our helpline a call. Youll be able to talk things through with highly trained advisors who have counselling skills and an extensive knowledge of diabetes.
The National Kidney Federation have kidney disease leaflets and can put you in touch with a local group. Kidney Care UK also offers resources and support including a telephone counselling service that you may find useful.
Kidney Research UK are dedicated to research into kidney disease. Weve been working together to identify the most important areas of future research, so that we can ultimately stop kidney disease in people with diabetes.
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Are There Different Types Of Diabetes
The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life.
Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans.
33% of drivers next to you on a busy highway could be at risk for kidney disease.
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What Increases The Risk Of Developing Diabetic Kidney Disease
All people with diabetes have a risk of developing diabetic kidney disease. However, a large research trial showed that there are certain factors that increase the risk of developing this condition. These are:
- A poor control of your blood sugar levels.
- The length of time you have had diabetes.
- The more overweight you become.
- Having high blood pressure. The higher your blood pressure, the greater your risk.
- If you are male.
This means that having a good control of your blood glucose level, keeping your weight in check and treating high blood pressure will reduce your risk of developing diabetic kidney disease.
If you have early diabetic kidney disease , the risk that the disease will become worse is increased with:
- The poorer the control of blood sugar levels. The greater your HbA1c level, the greater your risk.
- Having high blood pressure. The higher your blood pressure, the greater your risk.
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How Is Kidney Failure Treated
Kidney failure treatment is determined by the cause and extent of the problem. Treating your chronic medical condition can delay the progression of kidney disease. If your kidneys start losing their function gradually, your doctor may use one or more methods to track your health. By watching you closely, your doctor can help you maintain your kidneys function as long as possible.
Your doctor may gauge your kidney function with:
- Routine blood tests
- Blood pressure checks
Because the kidneys serve such an important purpose, people in kidney failure need treatment to keep them alive. The main treatments for kidney failure are:
- Dialysis: This treatment helps the body filter the blood .
- In hemodialysis, a machine regularly cleans your blood for you. People often receive this kidney failure treatment at a hospital or dialysis clinic, 3 or 4 days each week.
- Peritoneal dialysis cleans the blood in a slightly different way using a dialysis solution and a catheter. Sometimes, people can do their treatment at home.
Can A Patient With Diabetes Have A Kidney Transplant
Yes. Once you get a new kidney, you may need a higher dose of insulin. Your appetite will improve so your new kidney will break down insulin better than your injured one. You will use steroids to keep your body from rejecting your new kidney. If your new kidney fails, dialysis treatment can be started while you wait for another kidney. To learn more about kidney transplant .
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Serum Creatinine Blood Test
A serum creatinine blood test measures creatinine levels in your blood. Your kidneys remove creatinine from your body by sending creatinine to the bladder, where it is released with urine. If your kidneys are damaged, they cannot remove the creatinine properly from your blood.
High creatinine levels in your blood may mean that your kidneys are not functioning correctly. Your doctor will use your creatinine level to estimate your glomerular filtration rate , which helps to determine how well your kidneys are working.
How Can I Prevent It
Diabetic kidney disease can be prevented by keeping blood glucose in your target range. Research has shown that tight blood glucose control reduces the risk of microalbuminuria by one third. In people who already had microalbuminuria, the risk of progressing to macroalbuminuria was cut in half. Other studies have suggested that tight control can reverse microalbuminuria.
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Feeling Faint Dizzy Or Weak
Why this happens:
Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to feeling faint, dizzy, or weak.
What patients said:
I was always tired and dizzy.
It got to the point, like, I used to be at work, and all of the sudden I’d start getting dizzy. So I was thinking maybe it was my blood pressure or else diabetes was going bad. That’s what was on my mind.
When Should I Call The Doctor
A nephrologist receives special training in kidney evaluation and treatment. You may benefit from a kidney specialists expert opinion if:
- You have trouble keeping your blood pressure levels in a normal range, even with medication.
- Your blood sugar levels fluctuate widely.
Last reviewed by a Cleveland Clinic medical professional on 01/10/2018.
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How Is Diabetic Kidney Disease Diagnosed And Assessed
Diabetic kidney disease is diagnosed when the level of albumin in the urine is raised and there is no other obvious cause for this. Urine tests are part of the routine checks that are offered to people with diabetes from time to time. Urine tests can detect albumin and measure how much is present in the urine.
The standard routine urine test is to compare the amount of albumin with the amount of creatinine in a urine sample. This is called the albumin:creatinine ratio . Creatinine is a breakdown product of muscle.
A blood test can show how well the kidneys are working. The blood test measures the level of creatinine, which is normally cleared from the blood by the kidneys. If your kidneys are not working properly, the level of creatinine in the blood goes up. An estimate of how well your kidneys are working can be made by taking into account the blood level of creatinine, your age and your sex. This estimate of kidney function is called the estimated glomerular filtration rate .