Dr Vinant Bhargava

More and more people are suffering from diabetes globally. The prevalence of increasing diabetes means that the prevalence of diabetic kidney disease, one of the dangerous complications that increase mortality worldwide, also increases, explains nephrologist in Delhi.

What is diabetic kidney disease?

If high blood sugar persists, it will damage small blood vessels in the kidney. This can cause the protein to escape into the urine, resulting in symptoms such as hypertension, edema, and kidney damage. Finally, these injuries lead to serious kidney disease, end-stage kidney disease. Kidney disease caused by diabetes is called diabetic kidney disease.

Why is it important to know about diabetic kidney disease?

The worldwide prevalence of diabetes is increasing rapidly.
Diabetic kidney disease is the most common cause of chronic kidney disease, and 40-45% of newly diagnosed patients with end-stage kidney disease are diabetic.
Treatment of end-stage renal disease is more costly for patients in developing countries.
Early diagnosis and treatment can prevent diabetic kidney disease. Even with chronic kidney disease, proper treatment can delay the treatment of renal replacement therapy such as dialysis or kidney transplant in Delhi for a considerable period of time.
Management of diabetic kidney disease is more important because of the high mortality from cardiovascular disease.

Therefore, early diagnosis of diabetic kidney disease is very important in the treatment of patients, says the best nephrologist in Delhi.

How many diabetic patients lead to diabetic kidney disease?

There are two categories of diabetes, depending on which category it is likely to progress to diabetic kidney disease.

1) Type 1 diabetes-insulin-dependent diabetes mellitus

Type 1 diabetes occurs mainly in children, and insulin is essential for the treatment. Approximately 30-35% of patients are known to lead to diabetic kidney disease.

2) Type 2 diabetes – non-insulin dependent diabetes mellitus

Type 2 diabetes mellitus is predominantly in adults and is often treated without insulin in most patients. It is known that about 10-40% lead to diabetic kidney disease. Type 2 diabetes is the most common cause of chronic kidney disease in more than one of three chronic kidney disease patients, says kidney specialist in Delhi.

What type of diabetes leads to diabetic kidney disease?

Although it is difficult to predict which diabetes will lead to diabetic kidney disease, several key factors are known.

Type 1 diabetes mellitus that occurred before the age of 20
Unregulated blood sugar (high glycated hemoglobin)
Uncontrolled blood pressure

In the case of visual impairment such as diabetic retinopathy or nerve damage such as diabetic neuropathy
Proteinuria, obesity, smoking, hyperlipidemia

When does diabetes mellitus (diabetes) develop in diabetics?

Diabetic kidney disease (sickness) takes years to develop, so it rarely develops within the first 10 years. In type 1 diabetes, soybean red mildew symptoms occur between 15 and 20 years after the onset, and if it has not progressed to kidney disease for 25 years after the onset, the likelihood of developing kidney disease is lowered, says a doctor for kidney in Delhi.

When should a diabetic patient suspect a diabetic kidney disease?

Diabetic kidney disease (sickness) can be suspected if you have any of the following symptoms.

When foamy urine or urinary albumin/protein is present (observable early on)
Worsening of high blood pressure or previous hypertension
Edema of the ankle, foot or face; Decrease in urine volume or weight gain (due to the accumulation of water)
The decrease in insulin or diabetic drug requirements
Frequent hypoglycemia, or diabetes that has not been controlled in the past,
Drug-free diabetes: Many people think that diabetes has been cured because of good blood-sugar control, but in fact, it can mean kidney disease. In kidney disease, the duration of action of the diabetes drug is long.
Symptoms of chronic kidney disease at the end-stage (helplessness, fatigue, anorexia, nausea, vomiting, itching, pale, shortness of breath)
Elevation of creatinine and urea nitrogen in the blood test

How do you diagnose diabetes (kidney disease)?

Ideal: Diabetic patients should be tested for microalbuminuria and blood creatinine (or glomerular filtration rate) every year.
More practical: every three months blood pressure and urine dipstick tests are done. And every year we perform a blood creatinine (or glomerular filtration rate) test.

How can I prevent diabetic kidney disease?

The following are important to prevent diabetes (kidney disease).

Receive regular medical care from top nephrologist in Delhi.
Blood sugar control thoroughly. It is advisable to keep the glycated haemoglobin below 7%. Maintain blood pressure below 130/80 mmHg. Antihypertensive drugs such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are used to control blood pressure and albuminuria.
Sugar, salt, protein and fat intake should be reduced.
The microalbuminuria test and blood creatinine test (or glomerular filtration rate) should be performed at least once a year to determine the function of the kidneys.
Lifestyle therapy: Regular exercise and maintain ideal body weight. Do not smoke with alcohol, and avoid indiscriminate use of drugs such as an analgesic.

How do I treat diabetes (kidney disease)?

Thorough management of diabetes
Proper management of blood pressure is most important in protecting the kidneys. Therefore, blood pressure should be routinely measured and maintained below 130/80 mmHg. Treatment of hypertension is known to slow the deterioration of chronic kidney disease.
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are antihypertensive agents that have particular advantages in diabetic patients. These antihypertensive agents have the advantage of slowing the deterioration of nephropathy and should be initiated from early nephropathy in which microalbuminuria is present for maximum benefit.
To reduce facial or back swelling, you should administer a drug that increases urine, such as diuretics, with salt and water restriction.
Diabetic patients with renal insufficiency have a greater risk of falling into hypoglycemia and need appropriate controls for diabetic agents. Fast-acting insulin is preferred for controlling glucose and persistent oral formulations are contraindicated. Metformin is at increased risk for lactic acidosis and should not be used in patients with plasma creatinine> 1.5 mg / dL.
In diabetic patients with high plasma creatinine, all treatments for chronic kidney disease should be performed (listed in Chapter 12).
Risk factors that can cause cardiovascular diseases such as smoking, lipid elevation, hyperglycemia, and hypertension should be assessed and managed.
Patients with advanced diabetic kidney disease eventually need treatment such as dialysis or kidney transplant in Delhi.

When should a diabetic kidney patient consult a doctor?

Diabetic patients with microalbuminuria must consult the best kidney specialist in Delhi. You should consult your doctor immediately if:

The sudden increase in body weight, sudden decrease in urine volume, worsening of the face or leg edema, or difficulty breathing
Chest pain, aggravation of hypertension, and very fast or slow heart rate
Severe placebo, anorexia, vomiting or pale
Persistent fever and chills, and pain or burning fever during urination, urine or hematuria
When there is frequent hypoglycemia or reduced demand for insulin or diabetes
When confusion, drowsiness or convulsions of consciousness occurs

What you should eat to cleanse and take care of the health of your kidneys

Learn to identify the essential nutrients that help us purify the kidneys, those in charge of “filtering” everything we eat. Between the excesses of summer and the higher caloric intake that we consume in the fall, we have to take care of them.

If we take into account that the main function of the kidneys is the elimination of waste substances from the body through urine and that these are generated mainly from the food we eat every day, imagine how important is the diet to care for these organs.

FOODS THAT TAKE CARE OF YOUR KIDNEYS

And not only that, the main enemies of the kidneys (blood pressure and high blood sugar, which are the leading causes of kidney disease) also have a lot to do with everything we eat or, at least, can stay at bay with an adequate diet. So, Nephrologist in Delhi suggests watching the diet is a guarantee of health for your kidneys.

Keeping cholesterol at bay

Heart and kidney are very related. Therefore, to protect the kidney is essential to control cholesterol, one of the main cardiovascular risk factors. You get it by reducing in your diet the foods rich in saturated fats (red meats, whole milk …) and increasing the unsaturated ones (bluefish, nuts …). Use olive oil to cook, raise the good cholesterol.

Do not overdo the proteins

The kidney cleanses the blood of waste to expel it through the urine, and one of the main ones is urea, which is formed by the decomposition of proteins. Therefore, if you exceed your kidneys have to work more to eliminate urea and this can damage them. According to WHO, only 10-15% of daily calories should come from proteins. Red meats, whole milk products, and eggs are rich in them.

Control the salt

If you take a lot of salt the kidneys have a hard time removing excess sodium and that causes, in addition to thirst, fluid retention and hypertension, which can damage the blood vessels of the kidney. Kidney specialist in Delhi advises not to exceed 1.5 g of sodium per day. And do not forget that there is hidden salt in many foods (sausages, pre-cooked, cured cheeses, pickles …).

Do you control what you drink? This is how fluids affect the kidney

Water. To perform well its function is not necessary to drink more than 2 liters per day unless you have calculations because it helps to expel them.
Refreshments. The best are natural lemonades. Dark-colored sodas, fruit-flavored drinks or bottled or canned teas can have a lot of phosphorus.
Juices. If there is a kidney problem, the doctor for kidney in Delhi may recommend limiting the consumption of orange juice and replace it with apple, grape or pineapple.

Choose hydrates well

They are the main source of energy, but you must reduce the consumption of the simple ones (sugar, honey, jam, pastries, confectionery …) and increase the intake of complexes (whole grains and legumes). The reason? The first ones quickly turn into sugars and increase the risk of type 2 diabetes. And the high blood sugar we have already said is one of the main causes of kidney disease.

PAMPER YOUR KIDNEYS

If you have not hydrated well in the previous weeks, your kidneys may complain. So you can take care of them:

They need water to do their job well: Drink two liters of water of low mineralization daily. This helps them mobilize waste to be easily eliminated in the urine.
Fresh fruit and vegetables every day: These are the foods that most favor the purification function of the kidneys since, in addition to containing water, they are rich in potassium that increases the production of urine.

Go out in moderation and protect the jousts: According to the best nephrologist in Delhi, we should not exceed 5 grams of salt a day. When taken in excess, the kidneys can not eliminate it well and increases the risk of fluid retention and high blood pressure.

As for proteins, in a diet of 2,000 kcal, you should not eat more than 65g per day of this nutrient. It is proven that its excess hinders the work of the kidneys.

THE VEGETABLES RICHEST IN POTASSIUM

Fruits: The banana, the apple, the orange, the apricot, the peach, and the strawberries are the fruits with more potassium.
Vegetables: Potato, onion, celery, broccoli, cauliflower, and eggplant stand out as sources of this mineral.
Legumes and nuts: Take 2 or 3 servings of legumes a week and 25 g of nuts per day.

BEWARE OF PHOSPHORUS

It is also not convenient for you to drink a lot of phosphorus. It is necessary to have strong bones, but if the levels of phosphorus in the blood are high, the kidneys have a hard time eliminating the excess and this increases the risk of cardiovascular disease and osteoporosis. That is why it is not convenient to take it in excess. It is found in protein-rich foods and is also used as an additive in processed foods and soft drinks.

It is important to remember that dairy products provide phosphorus, so you should not take more than 2 a day. Look for ideas to replace them, you can, for example, include 3 pieces of fresh fruit (at breakfast and snack) and 2 servings of vegetables a day to keep your kidneys healthy.

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Diabetic Kidney Disease