In July I came face to face with someone who is diabetic, hypertensive, and had developed kidney problems. At the point I became aware of this person’s condition, it was already end stage renal failure. Dialysis had to be started immediately; however, the health care system unfortunately does not facilitate sessions being done for a while until the necessary paper work is completed. I saw firsthand the impact of the body systems breaking down, what it does to a person, and the impact it has on their family.
What does diabetes do to the kidneys?
With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, and eventually, waste materials will build up in your blood.
Diabetes may also cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. As well, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in the urine which has a high sugar level.
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. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high.
As your kidneys fail, your blood urea nitrogen levels will rise. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs), and anemia (a low blood count). You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.
How are the kidneys kept working as long as possible?
Other diseases can cause kidney damage. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year, to help lower your risk of developing severe kidney disease. Your kidneys will work better and last longer if you:
- – Control your diabetes
- – Control your high blood pressure
- – Get treatment for urinary tract infections
- – Correct any problems in your urinary system
- – Avoid any medicines that may damage the kidneys, (especially over-the-counter pain medications
You should check a nephrologist (kidney specialist), who will plan your treatment with you, your family and your dietitian. Your regimen could include the use of high blood pressure medicines called angiotensin converting enzyme ACE inhibitors, which have been shown to help slow the loss of kidney function.
Once you follow the instructions given, you stand a good chance of keeping the kidneys as healthy as possible, all things considered. Restricting protein in your diet might be helpful too; and, you and your dietitian can plan your diet together.
What is end stage renal failure in patients with diabetes?
End stage renal failure or kidney failure, occurs when your kidneys are no longer able to support you in a reasonably healthy state, and dialysis or transplantation is needed. This happens when your kidneys function at only 10 to 15 percent.
How is kidney failure treated in diabetic patients?
Three types of treatment can be used once your kidneys have failed: kidney transplantation, hemodialysis, and peritoneal dialysis.
Can a patient with diabetes have a kidney transplant?
Yes you can, but 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. Steroids will be prescribed 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.
What is the future outlook for patients with diabetes?
Currently, more and more research is being done in the area of diabetes. Hopefully, the prevention and cure of diabetes is in our future. In the meantime, you can manage your diabetes better with:
- – home monitoring of your blood glucose levels.
- – maintaining an awareness of controlling your blood pressure, and possibly monitoring your pressure at home.
- – following your special diet.
It is critical for persons with lifestyle diseases to be diligent, since sadly, the body is affected by each problem that attacks your varied body systems. In the process, some instances of long term problems could be prevented.
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