Diabetic Nephropathy

Diabetic Nephropathy Diabetic Nephropathy

What is diabetic nephropathy?

Diabetic nephropathy is a condition in which diabetes affects the kidney. It is considered a complication of type 2 diabetes as well as Type 1 Diabetes.  Diabetic nephropathy can result in kidney failure leading to requirement for dialysis in fact the most common cause of dialysis is  diabetic nephropathy.    

What are the signs of diabetic kidney disease?

Diabetic Kidney Disease unfortunately has few clinical features. This makes it hard for the diagnosis to take place in a timely manner.  Some of the symptoms may include puffiness of face, swelling in the legs, high BP, worsening of pre-existing high BP with requirement of more medication to control BP, anemia, chest pain, and breathlessness. 

How is diabetic nephropathy diagnosed at Magna?

At Magna, we diagnose using the recommended special test :urine -albumin creatinine ratio and serum creatinine. We also calculate the estimated GFR or EGFR using the creatinine measurement. Well before advanced damage to the kidney occurs due to diabetes, there are small amounts of albumin - a protein in blood - that will leak in the urine due to minor damage that is caused to the kidney. This small amount of albumin excretion is a warning sign that  further damage could harm the kidney faster. This test, also called as urine albumin creatinine ratio, can be done on a urine sample collected randomly at any time of the day. 

How long does diabetes take to damage kidneys?

Usually it takes almost 10 to 15 years following the onset of diabetes. In Type 1 Diabetes, timing of onset of diabetes is usually very clear as patients are very symptomatic as soon as diabetes starts. In case of type 2 diabetes this is not the case. In type 2 diabetes, diabetes can be present for a long duration without causing any symptoms. Due to this fact, diabetes may go unrecognized and may cause complications in the Kidney even at the time of diagnosis of type 2 diabetes.

Once Diabetic nephropathy is diagnosed, continuous follow-up is mandatory in order to prevent worsening. A more frequent follow-up than what is usually done for other patients will really help in reducing progression of diabetic nephropathy to end-stage renal disease. The frequency of follow-up is to make sure that the glucose, BP, anemia are all well-managed.

How is diabetic nephropathy treated at Magna?

Treatment for diabetes related nephropathy is through optimal control of blood pressure using medications called ACE inhibitors or ARB.  We also use a SGLT2inhibitors, a class of drug used to control blood glucose. These medications have also been recently shown to improve Diabetic nephropathy. Aggressive management of glucose and controlling the glucose to normal levels may prevent progression of Nephropathy.  Diabetic nephropathy is also accompanied by anemia and if anemia is not adequately treated it may contribute to worsening of Neuropathy  and poor quality of life for patients. Once anemia is diagnosed, we treat Anemia  using iron  infusions or oral iron supplements

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