What is DKD? DKD (DIABETIC KIDNEY DISEASE)

When a person’s kidney is affected due to diabetes, it is called Diabetic Kidney Disease. About 1 out of 4 adults with diabetes have kidney disease.(DKA)

Another name of  DKD is chronic kidney disease ( CKD ), kidney disease of diabetes, or diabetic nephropathy.

• What is diabetic kidney disease?
• How does diabetes cause kidney disease?
• What increases my chances of diabetic kidney disease?
• How can I tell if I have diabetic kidney disease?
• How can I keep my kidneys healthy if I have diabetes?
• How can I cope with the stress of managing my diabetes?
• Does diabetic kidney disease get worse over time?

FACTS OF DIABETIC KIDNEY DISEASE

• About 20 million Americans suffer from peripheral neuropathy.
• People with type 2 diabetes more likely to have diabetic neuropathy and pain due to complications than type 1 diabetics.
• Research shows that having a body mass index greater than 24 puts you at a higher risk for diabetes complications in general.

 

SYMPTOMS

• Diabetic kidney disease usually causes no symptoms until at least 75 percent of your kidneys’ function is lost.
• continuos high blood pressure
• Swelling of the hands, feet, and face.
• Trouble sleeping or concentrating.
• Nausea.
• Weakness.
• Itching (end-stage excretory organ) and dehydrated skin.
• Drowsiness (end-stage kidney disease)

DIAGNOSTIC TEST

To determine whether you have diabetic kidney disease, you may need certain tests and procedures, such as:

• Blood tests. If you have diabetes, you will need blood tests to monitor your condition and determine how well your kidneys are working.
• Urine tests. Urine samples provide information about your kidney function and whether you have too much protein in the urine.
• Imaging tests. Your doctor may use X-rays and ultrasound to assess your kidneys’ structure and size. You may also undergo CT scanning and magnetic resonance imaging (MRI) to determine how well blood is circulating within your kidneys.
• Renal function testing. Your doctor can assess your kidneys’ filtering capacity using renal analysis testing.
• Kidney biopsy. Your doctor may recommend a kidney biopsy to remove a sample of kidney tissue. You will be given a local anesthetic. Then your doctor will use a thin needle to extract small pieces of kidney tissue for examination under a microscope.

CAUSES OF DIABETIC KIDNEY DISEASE

• When the blood vessels are damaged due to high blood sugar.
• excessive smoking
• If you don’t follow the proper eating plan when you’re diabetic
• If you have a family history of kidney failure.

RISK FACTOR

• You have a high risk for DKD If you’ve high blood pressure.
• You have a high risk for DKD If you eat more salt in a food
• You have a high risk for DKD If you’re not active.
• You have a high risk for DKD. If you’ve any heart disease
• You have a high risk for DKD. If You’ve type 2 diabetes
• You have a high risk for DKD If  You’ve had type 1  diabetes for more than 5 years.

TREATMENT

• Healthy lifestyle habits and taking your medicines as prescribed can help you To treat Diabetic kidney disease.
• To maintain blood sugar level by routine checkup and proper treatment
• to maintain blood pressure
• Stop completely smoking
• Get enough sleep (7- 8 hour sleep each night)
• regular exercise or Yoga
• Cholesterol-lowering drugs called statins are used to treat high cholesterol and reduce protein in the urine.
• Medications can often reduce the level of the protein albumin in the urine and improve kidney function.

NATURAL TREATMENT

• vegetables and whole fruits: all kinds, which are high in antioxidants, fiber, vitamins, and essential electrolytes like minerals and potassium
• wild-caught fish: omega-3 fatty acids from fish oil benefits diabetics by lowering triglycerides and apoproteins that raise the risk for diabetic complications.
• Drink six to eight eight-ounce glasses of water each day to stay hydrated, plus fill up on more fiber-rich and water-rich foods like fresh veggies and fruit to feel satisfied with less
• Physical therapy can also be helpful because it increases muscle strength, mobility, and daily functioning.
• Essential oils to help dull pain and lower inflammation, including peppermint, lavender, and frankincense.

Diabetic nephropathy, also known as diabetic kidney disease, is the chronic loss of kidney function occurring in those with diabetes mellitus. Diabetic nephropathy is one of the leading causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) globally. Protein loss in the urine due to damage to the glomeruli may become massive and cause low serum albumin, resulting in generalized body swelling (edema) and nephrotic syndrome.

Likewise, the estimated glomerular filtration rate (eGFR) may progressively fall from a normal of over 90 ml/min/1.73m² to less than 15, at which point the patient is said to have end-stage renal disease. It usually is slowly progressive over the years.

Pathophysiologic abnormalities in diabetic nephropathy begin with long-standing poorly controlled blood glucose levels. Multiple changes follow this in the filtration units of the kidneys, the nephrons. (There are normally about 750,000–1.5 million nephrons in each adult kidney). Initially, there is constriction of the efferent arterioles and dilation of afferent arterioles, with resulting glomerular capillary hypertension and hyperfiltration; this gradually changes to hypo-filtration over time.

Concurrently, there are changes within the glomerulus itself: these include a thickening of the basement membrane, a widening of the slit membranes of the podocytes, an increase in the number of mesangial cells, and an increase in a mesangial matrix. This matrix invades the glomerular capillaries and produces deposits called Kimmelstiel-Wilson nodules. The mesangial cells and matrix can progressively expand and consume the entire glomerulus, shutting off filtration.

The status of diabetic nephropathy may be monitored by measuring two values: the amount of protein in the urine – proteinuria; and a blood test called the serum creatinine. The amount of proteinuria reflects the degree of damage to any still-functioning glomeruli. The serum creatinine value can be used to calculate the estimated glomerular filtration rate (eGFR), which reflects the percentage of glomeruli that are no longer filtering the blood.

Treatment with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker dilates the arteriole exiting the glomerulus, thus reducing blood pressure within the glomerular capillaries may slow (but not stop) progression of the disease. Three classes of diabetes medications – GLP-1 agonists, DPP-4 inhibitors, and SGLT2 inhibitors– are also thought to slow the progression of diabetic nephropathy.

Diabetic nephropathy is the most common cause of end-stage renal disease and is a serious complication that affects approximately one-quarter of adults with diabetes in the United States. Affected individuals with end-stage kidney disease often require hemodialysis and kidney transplantation to replace the failed kidney function. Diabetic nephropathy is associated with an increased risk of death in general, particularly from cardiovascular disease.

Diabetes – A Major Risk Factor for Kidney Disease

Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot properly use normal amounts of insulin. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body.

Are there different types of diabetes?

The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile-onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin, and you have to take insulin injections for the rest of your life.

Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult-onset diabetes mellitus. It is also called non-insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level can often be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans, and Asian Americans.

33% of drivers next to you
on a busy highway could be
at risk for kidney disease.

What does diabetes do to the kidneys?

With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.

Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in the urine with a high sugar level.

How many diabetic patients will develop kidney disease?

About 30 percent of patients with Type 1 (juvenile-onset) diabetes and 10 to 40 percent of those with Type 2 (adult-onset) diabetes eventually will suffer from kidney failure.

What are the early signs of kidney disease in patients with diabetes?

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The earliest sign of diabetic kidney disease is increased excretion of albumin in the urine. This is present long before the usual tests done in your doctor’s office show evidence of kidney disease, so you need to have this test every year. Weight gain and ankle swelling may occur. You will use the bathroom more at night.

Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine, and blood pressure checked at least once a year. This will lead to better control of your disease and early high blood pressure and kidney disease treatment. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.

What are the late signs of kidney disease in patients with diabetes?

As your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs), and anemia (a low blood count). You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.

Signs of Kidney Disease in Patients with Diabetes

1. Albumin/protein in the urine
2. High blood pressure
3. Ankle and leg swelling, leg cramps
4. Going to the bathroom more often at night
5. High levels of BUN and creatinine in the blood
6. Less need for insulin or antidiabetic medications
7. Morning sickness, nausea, and vomiting
8. Weakness, paleness, and anemia
9. Itching

 

https://www.diabetesasia.org/magazine/category/type-of-diabetese/type-2-diabetes/