Kidney Disease And Diabetes
One of the more common long-term complications of diabetes is kidney damage, also known as diabetic nephropathy or diabetic kidney disease. This condition is a result of vascular abnormalities that accompany diabetes and increases mortality risk. Type 2 diabetes is also a risk factor for end-stage renal disease , the most advanced stage of kidney disease.
Good Control Of Your Blood Pressure
Strict blood pressure control is likely to reduce the risk of developing cardiovascular diseases and prevent or delay the progression of kidney disease. Most people should already be taking an ACE inhibitor or AIIRA . These medicines lower blood pressure.
However, if your blood pressure remains at 130/80 mm Hg or more then one or more additional medicines may be advised to lower your blood pressure to below this level.
Signs Of Kidney Disease
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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.
What Is The Future Outlook For Patients With Diabetes
Today, more and more research dollars are spent on diabetes research. 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.
If you would like more information, please contact us.
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Reducing Your Hba1c To Reduce The Risk Of Nephropathy
Results from the ADVANCE study published June 2008 in the;New England Journal of Medicine trial showed that reducing HbA1c to 6.5% can lower nephropathy risk by a fifth in people with type 2 diabetes
Two further large-scale studies the Diabetes Control and Complications Trial and the UK Prospective Diabetes Study demonstrated that;decreasing HbA1c by 1% reduces the risk of microvascular complications, such as nephropathy, by 25% in people with either type 1 diabetes or type 2 diabetes
Antihyperglycemic Medication Selection And Dosing In Ckd
Many antihyperglycemic medications need to have their dose adjusted in the presence of low renal function, and some are contraindicated in people with significant disease. See;Figure 1;in Pharmacologic Glycemic Management of Type 2 Diabetes in Adults chapter, p. S88 and Appendix 7. Therapeutic Considerations for Renal Impairment.
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Types Of Kidney Failure In Dogs
There are two types of kidney failure, labeled as acute kidney failure and chronic kidney failure. Acute kidney failure means that your pets kidney failure occurs suddenly. This is usually caused by severe dehydration, a urinary obstruction, or due to poison ingestion, such as ingesting human medications, anti-freeze, or toxic plants. A very strong bacterial infection can also cause kidney failure.
Sometimes a dog may have other health concerns that can cause kidney failure due to decreased blood flow to the kidneys, such as during a surgical procedure, because of heatstroke, or related to heart disease.
Chronic renal failure, on the other hand, is a slow and insidious process that usually manifests over months and sometimes even years. This is the type of failure most common in elderly dogs. Unfortunately, chronic kidney disease is not typically reversible, especially when due to aging. By comparison, the damage done by acute kidney failure can be reversible if treated quickly enough.
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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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, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.
Diabetes also may 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. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.
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.
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Estimation Of Glomerular Filtration Rate
The eGFR is useful for assessing chronic changes in renal function but should not be used in situations where kidney function is changing rapidly. A rapid drop in renal function is referred to as an acute kidney injury . An AKI can occur in association with almost any acute systemic illness but, in particular, with conditions leading to hypotension or intravascular volume contraction. When such conditions are present, assessment of the level of kidney function may be clinically necessary, but should not be used to assess the stage of CKD. Because renal function can be transiently depressed, a persistent reduction in eGFR is required before it is considered to indicate the presence of CKD.
Table 4Stages of CKD of all types
How Are The Kidneys Kept Working As Long As Possible
The kidney doctor, called a nephrologist, will plan your treatment with you, your family and your dietitian. Two things to keep in mind for keeping your kidneys healthy are controlling high blood pressure in conjunction with an ACE inhibitor and following your renal diabetic diet. Restricting protein in your diet also might be helpful. You and your dietitian can plan your diet together.
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How Does Diabetes Increase The Risk For Kidney Disease
High levels of blood sugar make the kidneys work harder to do their filtering job. Over time, this can damage your kidneys so they start to leak small amounts of protein into the urine. The American Diabetes Association suggests that people with Type 2 diabetes have an albumin-to-creatinine ratio test at the time of diagnosis and once a year thereafter. Detecting albumin in a urine test indicates kidney damage. But not everyone with diabetes develops kidney disease. The better you keep you diabetes and blood pressure under control, the lower your chance of getting kidney disease.
Reach Your Blood Glucose Goals
Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.
The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.
To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.
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Treatments For Kidney Failure In Dogs
A staple treatment for dogs suffering from kidney failure is fluid therapy. Because of the large amount of water that is passed out of the body when a dogs kidneys are in distress, dehydration is common. Fluids are intended to help combat the problem of dehydration.
Withholding access to clean water because your pet may feel the need to pee a lot during the night could cause more damage than you think. Your dog needs access to fresh water around the clock, but this is especially true if your dog suffers from kidney problems.
Another important aspect of treating an animal experiencing renal failure is to keep track of the food and water they consume each day. You need know if they are drinking less than normal, because if they continue to drink less and less you will need to give them fluids to ward off dehydration. Weight loss is another concern in dogs with kidney disease. Weigh your dog frequently to make sure he or she is eating properly and maintaining a healthy weight.
Another thing thats important is feeding your dog a healthy diet. It is probably best to speak to your vet on the best way to provide this. Foods with a reduced amount of protein and lots of moisture content are important, but certain high protein foods contain phosphorus, and phosphorus levels must be carefully monitored in a dog suffering from renal failure.
Prediabetes And Kidney Disease
If you have prediabetes, taking action to prevent type 2 diabetes;is an important step in preventing kidney disease. Studies have shown that overweight people at higher risk for type 2 diabetes can prevent or delay developing it by losing 5% to 7% of their body weight, or 10 to 14 pounds for a 200-pound person. You can do that by eating healthier and getting 150 minutes of physical activity each week. CDCs National Diabetes Prevention Program lifestyle change program can help you create the healthy lifestyle habits needed to prevent type 2 diabetes. Find a program in your community or online.
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Symptoms Of Kidney Failure
For people with diabetes, kidney problems are usually picked up during a check-up by their doctor. Occasionally, a person can have type 2 diabetes without knowing it. This means their unchecked high blood sugar levels may be slowly damaging their kidneys. At first, the only sign is high protein levels in the urine, but this has no symptoms. It may be years before the kidneys are damaged severely enough to cause symptoms. Some of the symptoms may include:
- Fluid retention
Age Distribution For Diabetic Nephropathy
Diabetic nephropathy rarely develops before 10 years duration of type 1 DM. The peak incidence is usually found in persons who have had diabetes for 10-20 years. The mean age of patients who reach end-stage kidney disease is about 60 years. Although in general, the incidence of diabetic kidney disease is higher among elderly persons who have had type 2 diabetes for a longer generation, the role of age in the development of diabetic kidney disease is unclear. In Pima Indians with type 2 diabetes, the onset of diabetes at a younger age was associated with a higher risk of progression to end-stage kidney disease.
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How Can I Tell If I Have Diabetic Kidney Disease
Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.
Health care professionals use blood and urine tests to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.
You should get tested every year for kidney disease if you
- have had type 1 diabetes for more than 5 years
Using Medication For Prevention
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For People With Type 2 Diabetes
At the time the diabetes is first diagnosed, about 1 in 8 people have microalbuminuria and 1 in 50 have proteinuria. This is not because diabetic kidney disease happens straightaway in some cases but because many people with type 2 diabetes do not have their diabetes diagnosed for quite some time after the disease had begun.
Of those people who do not have any kidney problem when their diabetes is diagnosed, microalbuminuria develops in about 1 in 7 people and proteinuria in 1 in 20 people, within five years.
Diabetic kidney disease is much more common in Asian and black people with diabetes than in white people.
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.
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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.