Did you know that diabetes affects the kidney? Diabetic nephropathy (diabetic kidney disease) is one of the important specific complications of diabetes. Around 30 to 50 percent of people with kidney failure are diabetics.
Uncontrolled high blood sugar for long period of time produces functional and later structural changes in the kidneys. But what is unfortunate is that the changes occurring in kidneys are not clinically obvious to the treating doctor. The symptom the patient shows is until the kidney function is severely affected and the disease has reached an irreversible stage.
One popular and appropriate way of detecting early kidney damage in diabetes is through urine test. Presence of albumin leak in urine is called albuminuria of proteinuria.
In routine urine examination will detect albuminuria. However, as there are no symptoms this is not given any clinical importance and often goes unnoticed without medical care. Albumunuria is a symptom of early diabetic kidney disease. Aggressive treatment should start at this time and the progression of the kidney damage could be delayed or arrested.
Regular and routine examination of urine will detect albumunura. However, there is another sensitive test for detection of microabluminuria. This test detects minute amounts of albumin leaked into the urine (microabluminuria).
Microabluminuria is a sign of early abnormalities of the blood vessels (endothelial dysfunction) and a forerunner of atherosclerosis (hardening of arteries). Therefore presence of albuminuria is an indication to aggressive treatment of cardiovascular risk factors.
So, could we delay or prevent diabetic kidney disease with the available tools of medical treatment. Most research studies have shown that adequate and long-term control of blood sugar, blood pressure and nutritional changes can help in preventing kidney disease. However, the efforts should start early in the life of people with diabetes.
New classes of drugs used for treatment of hypertension are called angiotension-converting enzyme inhibitors. These agents were originally invented and used for treatment of hypertension. But they were found to be beneficial in preventing kidney disease in persons with diabetes, especially in patients who have albuminuria.
Other than the specific diabetes kidney disease, people with diabetes are also more prone to urinary tract infections. Chronic recurrent urinary tract infection is more common due to high blood sugar levels. Diabetes can also affect the nerves supplying the urinary bladder and produce abnormal bladder function (diabetes ystopathy). This can lead to deficient urinary evacuation and urinary retention. Therefore prevention of infections also helps in preventing kidney damage in diabetes.
So, remember, if you are a diabetic then have urine examination for albumin periodically to detect kidney disease.
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