Do you have diabetes? Or does someone in your family or close friend suffer from diabetes? Then this story will be very important to you. When we often think of diabetes, we only think of controlling blood sugar. But are we really aware of the damage that diabetes can cause to another very important organ in our body, our kidneys? That's what we're talking about today.
What is diabetic nephropathy?
Simply put, diabetic nephropathy is the gradual loss of kidney function caused by diabetes over time. In fact, diabetes is the leading cause of kidney failure worldwide. About one in three people with diabetes will develop this condition.
When someone with diabetes develops kidney disease, the situation can be a little more complicated than if they only have kidney disease without diabetes. This is because people with diabetes often have other health problems, such as high blood pressure, high cholesterol, and atherosclerosis . When all of these things are combined, the damage to the kidneys can be even greater.
This situation also varies slightly depending on the type of diabetes.
- In Type 1 diabetes: Kidney damage is relatively rare within the first 10 years after diagnosis.
- In Type 2 Diabetes: For some patients, even when the doctor says, "You have diabetes," their kidneys may have already begun to be damaged to some extent. That's why people with Type 2 diabetes need to be especially careful about this.
What are the symptoms of this condition?
The most dangerous thing about this is that there are no symptoms in the early stages. You may not notice any changes until significant damage has occurred to your kidneys. But as your kidneys begin to fail, the following symptoms may appear:
Imagine, your mother has diabetes. She can't do the things she used to do, she always says she's tired. When she wakes up in the morning, her legs and face are a little swollen. We think it's something that happens with age, or something that happens with fatigue. But these could be early signs of a kidney problem.
| Symptom | Description |
|---|---|
| Swelling of hands, feet, and face | This occurs because the kidneys fail to remove extra fluid from the body. |
| Sleep difficulties and decreased attention | The accumulation of waste products in the blood can affect brain function. |
| Loss of appetite and nausea | It is a common symptom caused by the accumulation of toxins in the body. |
| Weakness and extreme fatigue | A decrease in hormones produced by the kidneys can cause anemia (blood deficiency). |
| Dry skin and excessive itching | This can be seen in the final stages of kidney failure (end-stage kidney disease). |
| Heartbeat abnormalities | Increased potassium levels in the blood affect heart function. |
| Muscle twitching | It can be caused by calcium and phosphorus imbalances in the body. |
As the damage to the kidneys increases, they are unable to filter out waste products from the blood. These waste products can build up in the body and become toxic. This is called uremia . When this condition becomes severe, it can lead to confusion and even coma.
How to diagnose this disease?
The most important thing is to recognize this condition early. If you do, you can control or delay the progression to complete kidney failure.
The main and simplest way to detect this is a urine test. By checking the urine for protein (Urine for Microalbuminuria), this condition can be detected much earlier. That is why it is mandatory for a person with diabetes to have a urine test at least once a year.
Additionally, blood tests that check the levels of chemicals in the blood, such as creatinine, can give your doctor a good idea of the damage to your kidneys and how well they are working (eGFR).
What are the treatments?
When it comes to treatment, lifestyle changes are number one. Keeping your blood sugar and blood pressure under control is the best way to prevent further kidney damage.
In addition, there are special medications that can help control and delay kidney damage.
- SGLT2 inhibitors: These are a type of medication that helps control blood sugar and protect the kidneys. Examples include dapagliflozin (Farxiga) and empagliflozin (Jardiance).
- ACE inhibitors (Angiotensin-converting enzyme inhibitors): These are usually prescribed for high blood pressure. However, they are also prescribed to prevent kidney damage in people with diabetes. Even if your blood pressure is normal, your doctor may start you on these medications to protect your kidneys. Examples: ramipril (Altace), lisinopril (Prinivil).
- ARBs (Angiotensin II receptor blockers): If ACE inhibitors cause side effects such as coughing, this type of medication (ARBs) may be given instead.
Very important: Only your doctor can prescribe these medications. Do not use them based on what you read on the internet or what a friend recommends. Your doctor will examine you and prescribe the most appropriate medication and dosage for your condition.
If left untreated, the kidneys will gradually fail, the amount of protein in the urine will increase, and eventually dialysis or a kidney transplant may be necessary. Therefore, it is very important to be aware of this.
Take-Home Message
- Diabetes is the leading cause of kidney disease.
- Since there are often no symptoms in the early stages, it is important to have an annual urine test (Urine for Microalbumin) if you have diabetes.
- Kidney damage can be controlled by controlling blood pressure and blood sugar levels very well.
- If you experience symptoms such as swelling of the hands, feet, or face, extreme fatigue, or loss of appetite, do not ignore them and see your doctor immediately.
- It is very important to take your prescribed medications, especially those for diabetes, high blood pressure, and kidney disease, correctly and on time.
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