- What is diabetic nephrology and other complications?
Diabetic Nephropathy is a complication that occurs in diabetic patients which leads to permanent damage of blood vessels and cells of the kidney. This can occur for both Type 1 and Type 2 Diabetes mellitus. Upto 40 % of diabetic individuals can develop diabetic nephropathy. Diabetic nephropathy progress in stages 1 to 5. When the individual reaches stage 5 then he has to undergo renal replacement therapy (Dialysis or transplantation). The usual complications that occur with nephropathy include swelling in the feet, eyes and face. Persistent itching over the body, disturbed sleep, reduced urine volume, lack of appetite with vomiting suggest retention of toxic chemicals in the body due to kidney damage.
- What are the common mistakes a diabetes patient makes while dealing with kidney complications?
During the stage prior to kidney complications, there is increased thirst with good urine volume according to the fluid intake. When diabetic kidney disease occurs, the body tends to retain water and salt due to faulty kidney regulation. It is necessary for such patients to restrict the fluid intake to prevent body swelling.
Dosage of some of the regular medications might need to be modified in view of the kidney problem and other medications will need total withdrawal. Over the counter use of medications like pain relievers and antibiotics is strongly discouraged due to the adverse effects which include deteriorating kidney functions.
The diet will need to be modified with additional protein restriction once kidney disease is established. In general there is a risk for a spike in potassium levels and kidney patients are advised to restrict the fruits and juices due to the same.
People with diabetic kidney disease are very likely to develop high blood pressure and will need to start medications for the same. During the early phases of kidney disease, symptoms are very subtle, hence regular blood checkup is important to analyze the trend of kidney disease progression.
- What are the different treatments for such kidney complications/diseases?
The treatment begins with prevention of progression – this includes diligent sugar control, regular blood pressure checkup and adherence to prescribed diet plan. Individuals who are compliant to these parameters have a better chance to delay progression to kidney failure.
Modifications of medications is needed to achieve the goal and insulin would be a better choice during this phase.
Once the individual reaches stage 5 kidney disease he has the option of dialysis or kidney transplantation. Dialysis modalities include hemodialysis or peritoneal dialysis. In hemodialysis the blood is filtered with the help of a tube called dialyzer. Whereas, in peritoneal dialysis, the patient’s own abdomen cavity is utilized as a filtration tool.
In selected eligible individuals, they can opt for kidney transplantation if a suitable donor is available. They would require to continue medications lifelong to prevent kidney rejection after transplant.
Specialist Nephrologist
Aster Clinic, Bur Dubai (AJMC)
News Source : Khaleej Times
