Diabetic nephropathy is the silent, deadly complication of diabetes that ends in kidney dialysis and transplants. You can prevent it, but first you have to know it is there.
Diseases of the kidneys can have many causes, but diabetic nephropathy is the result of years of uncontrolled high blood sugar. It is another complication that comes with diabetes.
Less than half of type 2 diabetics develop diabetic kidney disease, and most of those only get it after many years of living with diabetes.
So why do you need to know about it? Because it is a silent disease.
It takes five to ten years with diabetic nephropathy before you begin to notice symptoms. But by that time the damage to your kidneys will be terrible.
You have two kidneys up under your ribs nestled on either side of your backbone.
An artery is attached to each of your kidneys. These renal arteries are big because they carry every drop of blood in your body through your kidneys day in and day out.
A kidney is made up of thousands of tiny balls called nephrons, and each of those is full of microscopic capillaries, the tiniest blood vessels.
These blood vessels are called glomerules, and they have one job. They constantly filter out liquid waste from your blood and send it to your bladder where it becomes urine.
Back in the late 1800s, doctors who cut open diabetic kidneys during autopsy found terrible scarring and damage to the nephrons. They knew they had found the cause of death.
Those blood vessels showed how the kidneys stopped working but not why. Then in the 1900s they finally made the connection with type 1 and type 2 diabetes.
But now they saw that high blood sugar over time will kill your kidneys, and that leads to death.
At last type 2 diabetes doctors knew what to watch for and made a blood test that would catch it early. As blood vessels in your kidneys begin to thicken and scar from high blood sugar, they leak protein, or albumin, into the urine.
That is why all diabetics get a urine test for microalbuminuria every year. It's a simple, quick way to find out whether you are developing diabetic nephropathy long before it does serious damage to your kidneys.
If you do not get this test done you'll have to wait until the symptoms appear to know you have diabetic nephropathy.
Five to ten years after the damage begins, you might find you have a poor appetite. You feel tired and ill with headaches, nausea and vomiting. Your legs might swell, and your blood pressure will soar out of control.
You will be very close to end stage kidney (or renal) disease, and the next step will be kidney dialysis. You may be put on a list for a kidney transplant too.
But even with those treatments many type 2 diabetics die from renal disease.
That is why early detection with urine and blood tests is essential to your diabetic management.
Get the test as soon and as often as it is recommended. Your regular visits to the doctor are very important to a type 2 diabetic.
If you have kidney disease, the first thing your doctor will do is lower your blood pressure. This will slow down the damage to your kidneys.
Then you will be asked to check your blood sugar more often and keep it low, usually under 150 for a start.
Lowering your bad cholesterol will help too, and if you can do this with diet and exercise you'll be doing your kidneys a big favor.
There is a special diet for kidney health that your doctor will want you to stick with. If you do this, it will help too.
If you have kidney disease you should know that the iodine dye used for some MRI and CT scans can badly damage kidneys that are already in trouble.
Also Celebrex, ibuprofen and naproxen are known to be hard on kidneys. Any medication that lists kidney problems of any kind as a side effect should be avoided.
Watch for kidney stones and gout that can furthur damage your kidneys. And be wary of diuretics, because some of them make nephropathy much worse. They can cause hypokalemic nephropathy.
Diuretics lower your potassium levels, and one symptom that warns you it is happening is restless legs syndrome. The cure for restless legs includes a high potassium diet of bananas, tomatoes, cantaloupe, figs, raisins, milk, potatoes and kidney beans.
The problem with that diet is it is directly opposed to the kind of diet a person with diabetic nephropathy needs to eat. A renal diet is designed to take the pressure off the kidneys by lowering the amount of potassium and salt in your food.
Many of us with type 2 diabetes are on diuretics such as furosemide. You need to take this up with your doctor if you start having higher albumin on your urine tests.
He may want to take you off diuretics unless there is some compelling reason to continue.
If you have high blood pressure, if you smoke, or if you are a type 1 diabetic who developed the disease before you were 20, that raises your risk.
If you have a family history of kidney disease you are also more at risk for developing diabetic nephropathy.
And if your blood sugar is not under good control, you are right in the path to get mowed down by complications like kidney disease.
It will not happen quickly, but the long-term cost is much too high to ignore taking care of your diabetic chores.
There are things you can do to protect your kidneys, and one of them is the healthy diet and exercise recommended for diabetics. Many of the superfoods protect and heal blood vessels.
It's up to you to make the choices and use what you know. If you neglect diabetic management, this condition will take over your life.
You need to know what you are dealing with. Then you will know what to expect and what to do to prevent complications like diabetic nephropathy. No one can make you take charge of your diabetic care but you.
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