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Diabetic nephropathy complications -

Kidney disease is a serious complication associated with diabetes. The kidneys are two bean-shaped organs located just below the ribs, near the back. Their job is to filter the blood so that waste is removed through the urine. The kidneys also regulate the amount of fluid and salt in the body and are important in controlling blood pressure.

The good news is that good diabetes management and regular kidney screening can prevent or delay the loss of kidney function. Over time, high blood sugar levels can damage tiny blood vessels in your kidneys, which means they cannot filter your blood properly. As a result, tiny particles of protein microalbumin spill into the urine; this is called microalbuminuria.

As kidney disease progresses, larger amounts of protein spill into the urine; this condition is called proteinuria. As kidney disease progresses, waste products start to build up in your blood because your body can't get rid of them.

If left untreated, your kidneys will eventually fail this is known as "end-stage renal failure" and dialysis or a kidney transplant will be required.

Diabetes can also affect the nerves that tell you when your bladder is full. The pressure from a full bladder can damage the kidneys. If urine remains in the bladder for a long time, it can increase your risk of developing a urinary tract infection, which can spread to the bladder.

Kidney disease is closely linked to high blood sugar, high blood pressure and smoking. The best way to prevent or delay kidney damage is to:. Over time, these high glucose levels can damage various areas of the body, including the cardiovascular system and kidneys.

The kidney damage that results is known as diabetic nephropathy. Diabetic nephropathy is a major cause of long-term kidney disease and end-stage renal disease ESRD. In ESRD, the kidneys no longer work well enough to meet the needs of daily life.

ESRD can lead to kidney failure with potentially life-threatening consequences. This article looks at how diabetes can affect the kidneys, the treatment available, and how to reduce the risk. Learn more about type 1 and type 2 diabetes. Nephropathy can affect people with any type of diabetes because it results from damage due to high blood glucose.

High blood glucose levels affect the arteries in the body, and the kidneys filter blood from those arteries. High levels of albumin in the urine : When the kidneys are healthy, the urine should contain none of the protein known as albumin. A low glomerular filtration rate GFR : A key function of the kidneys is to filter the blood.

Kidney damage affects their ability to do this. ESRD is the last stage of kidney disease. Diabetic nephropathy is the most frequent cause of ESRD in the United States.

A person with ESRD will require dialysis. Managing blood sugar levels can reduce the risk. Whether a person has type 1 or type 2 diabetes, they can reduce the risk of diabetic nephropathy by:. What is chronic kidney disease? Find out more here. Damage to the kidneys puts stress on these vital organs and prevents them from working properly.

Diabetic nephropathy develops slowly. According to one study, a third of people show high levels of albumin in their urine 15 years after a diagnosis of diabetes. However, fewer than half of these people will develop full nephropathy. Statistics have suggested that kidney disease is uncommon in people who have had diabetes for less than 10 years.

Also, if a person has no clinical signs of nephropathy 20—25 years after diabetes starts, they have a low chance of developing it thereafter. Diabetic nephropathy is less likely if a person with diabetes manages their glucose levels effectively.

High blood glucose levels increase the risk of high blood pressure because of the damage to blood vessels. Having high blood pressure, or hypertension , may contribute to kidney disease. Smoking : Kidney damage may result from a link between smoking and higher levels of inflammation.

While the link between smoking and diabetes remains unclear, there appears to be a greater incidence of diabetes, as well as hypertension and kidney disease, among people who smoke. Age : Kidney disease, and especially a low GFR is more common in people aged 65 years and above.

Race, ethnicity, or both : It is more common in African Americans, Native Americans, and Asian Americans. Health conditions : Having obesity , chronic inflammation, high blood pressure, insulin resistance , and elevated levels of blood lipids fats can all contribute to kidney disease.

Some of these risks either are or appear to be contributing factors to or complications of diabetes. Diabetic nephropathy is not the same as diabetic neuropathy , which affects the nervous system.

Learn more here about diabetic neuropathy and peripheral neuopathy. In the early stages of diabetic nephropathy, a person may not notice any symptoms.

However, changes in blood pressure and the fluid balance in the body may already be present. Over time, waste products can build up in the blood, leading to symptoms.

A doctor may break down the stages of kidney disease, depending on the GFR, which also represents the percentage of effective kidney function. In the early stages, a person may not notice any symptoms.

At stage 4 or 5, they may feel unwell and experience the following symptoms:. Following a treatment plan for diabetes and attending regular health checks can help a person with diabetes control their blood sugar levels, reduce the risk of kidney problems, and find out early if they need to take action.

Screening involves a person taking a urine test to check for proteins in the urine. However, having proteins in the urine does not necessarily indicate kidney disease, as it could also be due to a urinary tract infection. The main aim of treatment is to maintain and control blood glucose levels and blood pressure.

This may involve the use of medication. Angiotensin converting enzyme ACE inhibitors or angiotensin receptor blockers ARBs can help lower blood pressure, protect kidney function, and prevent further damage. Kerendia finerenone is a prescription medicine that can reduce the risk of sustained GFR decline, end-stage kidney disease, cardiovascular death, nonfatal myocardial infarction, and hospitalization for heart failure in adults with CKD associated with type 2 diabetes.

A doctor may also prescribe vitamin D , as people with kidney disease often have low vitamin D levels, or a statin to reduce cholesterol levels. In , the American College of Cardiology issued guidelines recommending the use of sodium-glucose cotransporter 2 SGLT2 inhibitors or glucagon-like peptide-1 receptor agonists GLP-1RAs for people with type 2 diabetes and CKD.

These drugs may reduce the risk of CKD progression, cardiovascular events, or both. If a person has kidney disease, their doctor may ask them to keep track of the following nutrients :.

Water : Although essential, too much water or fluid may increase the risk of swelling and high blood pressure. Protein : For a person with kidney disease, protein can cause waste to build up in the blood, putting extra pressure on the kidneys.

Phosphorus : This occurs in many protein and dairy foods. Too much phosphorus can weaken the bones and put pressure on the kidneys.

Potassium : People with kidney disease can have higher levels of potassium than is healthful, which can affect nerve cells. Click here to learn more about the high potassium foods a person should avoid if they have kidney disease. This is crucial for lowering the risk of diabetes complications, such as kidney disease, cardiovascular disease, and diabetic neuropathy , which affects the nervous system.

These conditions, too, can lead to further complications. Managing blood sugar levels can also help prevent these from developing. If diabetic nephropathy progresses to ESRD, a person will need either dialysis or a kidney transplant.

They will usually need dialysis for the rest of their life or until a kidney transplant is available. Kidney dialysis is a procedure that typically uses a machine to separate waste products from the blood and remove them from the body. Dialysis acts as a substitute for a healthy kidney. Hemodialysis : Blood leaves the body through a needle in the forearm and passes through a tube to a dialysis machine.

The machine filters the blood outside the body, and the blood returns through another tube and needle. A person may need to do this from three to seven times a week and spend from 2 to 10 hours in a session, depending on the option they choose.

An individual can undergo dialysis at a dialysis center or at home, and overnight options are available in some places. Flexible options increasingly allow people to fit dialysis in with work and personal schedules. Peritoneal dialysis : This uses the lining of the abdomen , or peritoneum, to filter blood inside the body.

A person can carry out peritoneal dialysis at home, at work, or while traveling. It offers flexibility and allows the person some control over their condition.

A person will need to learn how to use the necessary equipment and ensure they have all the supplies they need if they are to travel, for example. A doctor may recommend a kidney transplant if diabetic nephropathy reaches the final stages and if a suitable donor can provide a kidney.

Finding a donor may take some time.

Diabetic nephropathy complications Nfphropathy. GrossMirela J. de NepgropathyDiabetic nephropathy complications P. SilveiroLuís Henrique CananiMaria Luiza CaramoriThemis Zelmanovitz; Diabetic Nephropathy: Diagnosis, Prevention, and Treatment. Diabetes Care 1 January ; 28 1 : — It increases the risk of death, mainly from cardiovascular causes, and is defined by increased urinary albumin excretion UAE in the absence of other renal diseases.