Diabetic nephropathy. A dangerous disease that gives no symptoms for years. A simple examination is the answer

It should be borne in mind that diabetic nephropathy, although it is a little known disease and for a long time without any symptoms, is not a rare disease. It is tricky and dangerous – writes prof. dr hab. n. med. Ryszard Gellert, national consultant in the field of nephrology, director, Medical Center of Postgraduate Education.

1. Diabetic kidney disease (diabetic nephropathy) is one of the late complications of diabetes
2. The first changes in the kidneys become visible after 5-10 years on average
3. On the other hand, the first sign of developing diabetic nephropathy appears earlier – it is laboratory-detected proteinuria
4. More information can be found on the Onet homepage

It is not always possible to prove that chronic kidney disease is a complication of diabetes. Diabetes does not protect against the development of other kidney problems, and patients with other kidney problems may also have diabetes. Nevertheless, diabetic nephropathy is the most common reason for initiating dialysis treatment. For this reason, any patient with diabetes must be very carefully monitored for both diabetic kidney disease and other kidney disease. It cannot be that a diabetic patient does not have a regularly measured creatinine level and a general urine test performed, because these tests allow the detection of early kidney dysfunction – most likely caused by diabetes (but only – most likely).

Diabetic nephropathy significantly shortens life

The diagnosis must be very accurate as treatment for diabetic nephropathy is different than for other kidney diseases. Treatment of diabetic kidney disease is primarily based on excellent glycemic control and the use of medication appropriate to the patient’s condition, while treatment of other kidney diseases in diabetic patients often requires anti-inflammatory or immunosuppressive therapy.

As it is a completely different treatment, early diagnosis and the early initiation of appropriate therapy play a huge role here. The goal is to avoid what is most tragic, i.e. complete destruction of the kidneys. This is also important because diabetes shortens life, but kidney disease shortens life even more. Anyone with chronic kidney disease, such as diabetic nephropathy, has an estimated 30% shorter life expectancy – regardless of age. Thus, for a 40-year-old, this is about 12 years of reduced life span.

If diagnostics and treatment are not taken care of and damage is allowed to over 50% of the kidneys, then the expected survival time is reduced by 80%. This means that someone will live only 20 percent. what it should! So it’s worth fighting so that diabetes does not damage the kidneys. However, it needs to be treated early and done well and systematically.

The rest of the text is below the video.

It depends on the patient whether and when he or she will go to the nephrologist

Diabetes mellitus is not a disorder that can be easily treated, for example with herbs. It is a complicated metabolic disease that destroys many parts of the body, including blood vessels. Damage to the vessels in the kidneys in a diabetic patient is very important, because every fifth drop of blood flows through these organs. The kidneys are very well supplied with blood, but the numerous blood vessels there are extremely sensitive to glycemic disorders. High blood glucose levels result in kidney abnormalities developing very quickly, and the damage caused by unstable diabetes itself is also very rapid. So you can see that kidney disease is extremely dangerous; they also accelerate atherosclerosis in all types of vessels, including the coronary system. For this reason, it is worth following the doctor’s instructions and scrupulously performing tests – without cheating, because only on the basis of reliable results, the diabetologist will be able to send the patient to a nephrologist early enough.

In Poland, we have very good diabetes and nephrological care. However, the doctor is only a consultant, a guide in the treatment process, while the patient is treated and he is responsible for the implementation of his treatment. Because it is the patient who comes to the doctor’s appointments, performs the prescribed examinations, takes medications, and doses exercise. Or it doesn’t do all of that. Another problem is the patients’ inconsistency in acting or loosening the self-discipline that is required in the treatment of diabetes.

If the doctor orders any tests or consultations, you can ask what the purpose of this is, but the patient in charge of his or her health should have a doctor’s recommendation or an examination performed, because methods and treatment measures are selected based on the results of the tests. Performing tests is very important in the case of diabetic nephropathy, as this disease does not cause any symptoms. Only abnormal laboratory test results inform about it for a long time.

Diabetic nephropathy can be reversed, but …

Diabetic kidney disease can be reversed in its early stages – provided the patient makes an effort on his part to enable it to do so. Otherwise, the disease will become progressive until it reaches the point where the decline in kidney function is constant and continuous – the progression of the disease can only be slowed down, but not stopped. Therefore, diagnosis of chronic kidney disease should be carried out as early as possible.

Diet is the cornerstone of the treatment of diabetes and diabetic kidney disease. Treatment with a diet is simple when a diabetic is to avoid carbohydrates due to impaired glycaemia. However, when chronic kidney disease joins diabetes, it is also necessary to avoid protein in the diet. And the matter becomes more complicated. You can base your menu on fats, but this in turn increases the risk of atherosclerosis. Therefore, also because of the problems with composing a diet, diabetes should be treated as early as possible.

We have drugs that are very effective in treating diabetes, but most of them can be used in patients until they develop chronic kidney disease. Until now, we had great difficulty choosing medications, and kidney failure really had to be switched to insulin. Recently, we finally have drugs that can be administered to patients until they have diuresis – until there is 25% glomerular filtration rate. Thus – the period when this treatment can be started and continued is very long.

Therapy is expensive, unfortunately, but thankfully it exists, and you don’t need to take insulin because drugs are designed to block sugar reabsorption in the kidneys. In this way, even tens of grams of glucose can be removed from the body along with urine. This is a treatment that requires the patient to drink plenty of fluids – keep this in mind.

Insulin must be used when there is no other way.

The article comes from the educational campaign “Diabetes under control” prepared by Warsaw Press. All materials can be found on http://www.warsawpress.com/