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KIDNEY DISEASE OF DIABETICS :FACTS

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  • Symptoms of chronic kidney disease vary greatly and can include the need to urinate frequently, especially at night; swelling of the legs and puffiness around the eyes, high blood pressure, fatique and weakness; loss of appetile, nausea and vomating; itching and easy bruising ;shortness of breath; headaches, sleep problems, restless legs syndrome; chestpain; bleeding; bone pain; and decreased interest in sex and erectile dysfunction.
  • Treatment of diabetes, blood sugar ,includes control of blood glucose levels, high blood pressure, and diet; medications to treat edema and anemia, dialysis, or kidney transplant.
  • Controlling blood glucose levels and blood pressure is the most effective way to prevent or delay kidney disease.

The burden of kidney failure

  • More than 17% people in India are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of chronic kidney disease (CKD).
  • Diabetes is the most common cause of kidney failure, accounting for nearly 44 percent of new cases. Even when diabetes is controlled, the disease can lead to chronic kidney disease and kidney failure. Most people with diabetes do not develop chronic kidney disease that is severe enough to progress to kidney failure. Nearly 42.5 % people in the India have diabetes, and nearly 200,000 people are living with kidney failure as a result of diabetes.

Primary Causes of Kidney Failure 2005

2.5%  Urologic Diseases

2.3%  Cystric Diseases

7.6%   Glomerulonephritis

26.8%  High Blood Pressure

43.8% Diabetes

17.5% Other

They have found that high blood pressure and high levels of blood glucose increase the risk that a person with diabetes will progress to kidney failure

The course of kidney disease

Diabetic kidney disease takes many years to develop. In some people, the filtering function of the kidneys is actually higher than normal in the first few years of their diabetes.

Over several years, people who are developing kidney disease will have small amounts of the blood protein albumin  begin to leak into their urine. This first stage of chronic kidney disease is called micro albumin uria. The kidney’s filtration function usually remains normal during this period.

As the disease progresses, more albumin leaks into the urine. This stage may be called macro albumin or proteinuria. As the amount of albumin in the urine increases, the kidneys’ filtering function usually begins to drop. The body retains various wastes as filtration falls. As kidney damage develops, blood pressure often rises as well.

Overall, kidney damage rarely occurs in the first 10 years of diabetes, and usually 15 to 25 years will pass before kidney failure occurs. For people who live with diabetes for more than 25 years without any signs of kidney failure, the risk of ever developing it decreases.

Effects of High Blood Pressure

High blood pressure, or hypertension, is a major factor in the development of kidney problems in people with diabetes. Both a family history of hypertension and the presence of  appear hypertension to increase chances of developing kidney disease. Hypertension also accelerates the progress of kidney disease when it already exists.

Blood pressure is recorded using two numbers. The first number is called the systolic pressure, and it represents the pressure in the arteries as the heart beats. The second number is called the diastolic pressure, and it represents the pressure between heartbeats. In the past, hypertension was defined as blood pressure higher than 140/90, said as “140 over 90.”

The ADA and the National Heart, Lung, and Blood Institute recommend that people with diabetes keep their blood pressure below 130/80.

Hypertension can be seen not only as a cause of kidney disease but also as a result of damage created by the disease. As kidney disease progresses, physical changes in the kidneys lead to increased blood pressure. Therefore, a dangerous spiral, involving rising blood pressure and factors that raise blood pressure, occurs. Early detection and treatment of even mild hypertension are essential for people with diabetes.

Preventing and Slowing Kidney Disease

Blood Pressure Medicines

Scientists have made great progress in developing methods that slow the onset and progression of kidney disease in people with diabetes. Durgs used to lower blood pressure can slow the progression of kidney disease significantly. Two types of drugs, angiotensin-converting enzyme (ACE) inhibitors and angio-tensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more drugs to control their blood pressure. In addition to an ACE inhibitor or an ARB, a diuretic can also be useful. Beta blockers, calcium channel blockers and other blood pressure drugs may also be needed.

An example of an effective ACE inhibitor is lisinopril, (Prinivil , Zestril),which doctors commonly prescribe for treating kidney disease of diabetes. The benefits of lisinopril extend beyond its ability to lower blood pressure: it may directly protect the kidneys’ glomeruli. ACE inhibitors have lowered proteinuria and slowed deterioration even in people with diabetes who did not have high blood pressure.

An example of an effective ARB is losartan (Cozaar), which has also been shown to protect kidney function and lower the risk of cardiovascular events.

Any medicine that helps patients achieve a blood pressure target of 130/80 or lower provides benefits. Patients with even mild hypertension or persistent micro albuminuria should consult a health care provider about the use of antihypertensive medicines.

Moderate-protein Diets

In people with diabetes, excessive consumption of protein may be harmful. Experts recommend that people with kidney disease of diabetes consume the recommended dietary allowance for protein, but avoid high-protein diets. For people with greatly reduced kidney function, a diet containing reduced amounts of protein may help delay the onset of kidney failure. Anyone following a reduced-protein diet should work with a dietitian to ensure adequate nutrition.

Intensive Management of Blood Glucose

Antihypertensive drugs and low-protein diets can slow chronic kidney disease. A third treatment, known as intensive management of blood glucose or glycemic control, has shown great promise for people with diabetes, especially for those in the early stages of chronic kidney disease.

The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body’s cells. To enter cells, glucose needs the help of insulin, a hormone produced by the pancreas. When a person does not make enough insulin, or the body does not respond to the insulin that is present, the body cannot process glucose, and it builds up in the bloodstream. High levels of glucose in the blood lead to a diagnosis of diabetes.

Intensive management of blood glucose is a treatment regimen that aims to keep blood glucose levels close to normal. The regimen includes testing blood glucose frequently, administering insulin throughout the day on the basis of food intake and physical activity, following a diet and activity plan, and consulting a health care team regularly. Some people use an insulin pump to supply insulin throughout the day.

In Ayurveda there are several herbs that help in sugar absorptions in blood stream, kidney detoxification and also in managing your blood pressure:

  • Strelax
  • Sugafite
  • Sugarest
  • Detox Me
  • Detox K
Profile photo of Ranjana Mishra
Ranjana Mishra
Ranjana is a MSc. in Life Sciences (Bio-Chemistry) and is presently pursuing Phd. in Bio-Molecules. She is in the Products Research & Development Department in Herbalage and had got immense knowledge on Health & Diseases which she is sharing with us via her articles.
http://herbalage.in

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