Diabetic Nephropathy Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Diabetic nephropathy is a condition of decreased kidney function caused by diabetes mellitus (DM). Nearly 40% of DM sufferers will experience various complications, including this type of complication. However, with good DM management, such as controlling blood sugar and blood pressure, nephropathy can be prevented and is very likely to be slowed down.
Diabetic nephropathy can attack people with type 1 and type 2 DM. This health problem is divided into five stages. In the final stages, it is called end-stage renal disease or ESRD ( end-stage renal disease ). It usually takes nearly 20 years for a person to reach that final stage.
Symptom
At first, diabetic nephropathy rarely causes significant symptoms. Usually, new symptoms appear when the condition is already at a fairly severe stage.
The following symptoms will appear around the fourth stage:
- Swelling of the ankles, feet, lower legs or hands caused by water retention
- Dark urine is caused by blood in the urine
- It is easy to feel short of breath, for example when climbing stairs
- Fatigue due to lack of oxygen in the blood
- Nausea or vomiting
Reason
Diabetes mellitus in principle affects the condition of the arteries in the body, including the blood vessels in the kidneys which work to filter blood from many arteries. High sugar levels in blood vessels can damage small blood vessels such as the kidneys. That’s why kidney problems are a scourge for people with DM.
Statistically, there is also a relationship between kidney problems in diabetes and the emergence of hypertension or high blood pressure. People with diabetes and high blood pressure are also at a faster risk of developing diabetic nephropathy. It can even occur in a more severe stage.
Diagnosis
Diabetic nephropathy is known from kidney function tests and protein levels in urine samples. If symptoms of microalbuminuria and decreased kidney function occur, it can be said that a person is also experiencing diabetic nephropathy.
Microalbuminuria is a condition where there is a high level of protein albumin in the urine. When a lot of albumin levels are found in the urine (macroalbuminuria), it means that the kidneys have experienced quite severe disorders and are at risk of leading to kidney failure. This kind of more severe stage can also be known from other physical symptoms.
Treatment
Treatment of diabetic nephropathy depends on many factors, such as:
- age, medical history and general condition of the body
- disease stage
- tolerance to drugs, procedures or therapy
- personal opinion
Keeping blood sugar levels under control is the first goal of treatment for diabetes and its complications. The condition of diabetic nephropathy can also improve if diagnosed early, accompanied by the following steps:
- Eat a healthy diet (limiting the amount of protein and salt will be beneficial to maintain the condition of the kidneys)
- Get regular exercise
- Avoid alcohol and cigarettes
- Check blood glucose levels regularly
In some patients who also experience high blood pressure disorders, anti-hypertensive drugs such as ACE ( angiotensin-converting enzyme ) inhibitors or ARBs ( angiotensin receptor blockers ) can usually be given. Maintaining blood pressure is also important to try to prevent further damage to the kidneys.
The fifth or terminal stage of diabetic nephropathy is kidney failure. Treatment at this stage includes:
- Kidney dialysis or dialysis
- Kidney transplant
Prevention
Prevention of diabetic nephropathy can only be done by doing good DM management such as continuing to control blood sugar levels so that they are under control. Maintaining blood pressure at normal levels can also help prevent diabetes complications.
Studies show that lowering HbA1c levels (a component of hemoglobin related to glucose) to 6.5% can reduce the risk of diabetic nephropathy by 21% in people with type 2 DM. Meanwhile, lowering HbA1c levels by only 1% can reduce the risk of microvessel complications in DM. including diabetic nephropathy, as much as 25% in both type 1 and type 2 DM.
Because generally diabetic nephropathy is only discovered when it is in its final stages, it is recommended that people with DM have a kidney function examination every year. To find out the complications of diabetes in the early stages, follow the doctor’s recommendations to carry out various checks regularly.