Risk factors for Diabetic Nephropathy :
- Poor glycaemic (blood glucose) control
- Genetic (Family history)
- Smoking, Alcohol or Tobacco intake
- Duration and severity of diabetes
Clinical Features of Diabetic Nephropathy :
During Early stages of Nephropathy, there are usually no symptoms. As the conditions progress, individuals with diabetic nephropathy may show
- Oedema on feet and legs, later oedema may occur throughout the body.
- Increase blood pressure and elevated levels of cholesterol and triglycerides in the body.
- Large amount of protein leaking into the urine
Once the kidneys are severely damaged, blood sugar levels may drop because kidney retains insulin or medicines in the body (The half-life of medicines increases). In late stages, the patients become
- Anaemic (Kidney produces hormone erythropoietin, it stimulate red blood cell production.
- Increase Serum potassium level
- Urinary Albumin/Creatinine Ratio (mg/g) Spot Sample for measurement of microalbuminuria
- Normal: less than 30 mg/g
- Microalbuminuria : 30 to 299 mg/g
- Macroalbuminuria: more than 300 mg/g
- Blood test for serum creatinine: Creatinine is a by-product of muscle metabolism and it is excreted by the kidney. The normal range of serum creatinine is as follow :
- Adult Males : 0.8-1.4 mg/dL
- Adult Females :0.6-1.1mg/dL
- Children : 0.2-1.0 mg/dL
- Estimate GFR (Glomerular Filtration Rate): eGFR indicates how well the kidneys are functioning.
Although diabetic nephropathy cannot be cured, the progression of the disease can be slow down by :
- Avoid nephrotoxic drugs such as Painkillers (NSAID'S and COX-2 inhibitors).
- Glucose control
- Intensive treatment of blood pressure should aim for 130/80 mmHg. BP lowering medicines may slow down kidney damage and are started as soon as any amount of proteins is found in the urine.
- Dietary protein is to be restricted to 0.8 g of proteins/kg body weight and reduce salt in the diet. (5-6gm of Salt/day)
- Quit Smoking, Alcohol, and Tobacco
This is Copyright Content by Gadge's Diabetes Care Edited and written by Madiha Khan