World Kidney Day 2023 – Kidney health for all |09 March 2023
Preparing for the unexpected, supporting the vulnerable!
Diabetic nephropathy is the name given to kidney disorders that occur in people with diabetes mellitus, when their blood glucose control and other associated factors have not been adequate. It is one of the chronic complications of diabetes mellitus, which can occur in both type 1 and type 2 diabetes, and has very serious repercussions on the lives of patients.
Diabetic nephropathy is responsible for about 30% of patients on periodic dialysis and the leading cause of kidney transplantation in Western countries.
Diabetic nephropathy is usually completely asymptomatic in its early stages, until severe damage occurs that affects kidney function (renal failure). In the early stages of the disease, proteinuria usually appears in urine tests, this is the presence of protein in the urine, it is usually due to the deterioration of the filters present inside the kidney, called nephrons.
One of the most important signs of the disease is the presence of foam in the urine, the formation of foam is intense, as in beer, and it takes time to disappear.
When diabetic nephropathy reaches late stages, it is practically irreversible, therefore its early detection is very important and prevent its progression when it is diagnosed. This requires regular blood and urine tests (at least once a year in people with type 2 diabetes) to early detect inappropriate loss of protein in the urine (albuminuria) and impaired kidney function.
The factors that contribute to the deterioration of kidney function include the time of evolution of diabetes, since it appears in 50% of patients 20 years after the onset of diabetes. Also the presence of arterial hypertension, since it is the most important risk factor in diabetics for the development of renal failure. Other factors that can affect the renal function are obesity, hyperlipidaemia, and tobacco, among others.
The use of some antihypertensive drugs has shown efficacy in controlling the progression of the disease. Likewise, it is very important to control blood pressure and lipid levels, maintain a healthy weight and practice regular physical activity.
In cases of established diabetic nephropathy, it is advisable to reduce the amount of protein in the diet by following a specific eating plan.
Dialysis may be necessary once end-stage renal disease is established. At this stage, the possibility of a kidney transplant should be considered.
Being a disease with a high incidence due to a very frequent disease, which is diabetes mellitus, which is suffered by approximately 422 million people worldwide, and which is constantly increasing, we recommend strict control of blood glucose levels and adequate follow-up of the disease with the doctor. Keeping diabetes under control, we can avoid chronic complications such as kidney failure, blindness and cardiovascular disease.
Dr Iyad Abu-Sharkh Abuward
MD, PhD Consultant Nephrology
Interventional Nephrologist
Medical Director of AMSA Renal Care Group