What causes nephropathy in diabetes?

Dr Abdulla

What causes nephropathy in diabetes?

diabetic nephropathy is a long-term kidney disease that can affect people with diabetes. It occurs when high blood glucose levels damage how a person’s kidneys function. Diabetic nephropathy is a kind of chronic kidney disease (CDK).

Diabetic nephropathy

Diabetic nephropathy is a phenomenon that can usually be expected in 20%-40% of patients with type 1 and type 2 diabetes.

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After the onset of diabetic nephropathy, the disease progresses and worsens for several years until reaching an incurable state of renal failure that requires dialysis or transplantation of a new kidney.

For chronic renal failure , which is incurable in diabetic patients is one of the most difficult and the most serious complications of diabetes, as it leads to very high rates of mortality, have registered in recent years a growing increase in the number of patients with diabetes, especially type II, and in the number of patients affected they have kidneys.

Prolonging the lives of diabetics with treatments has prevented death from cardiovascular diseases, and a steady decrease in the number of diabetics requiring dialysis treatment.

Stages of diabetic nephropathy

There are five stages of diabetic nephropathy, which are as follows:

1. The first stage of diabetic nephropathy

Excessive filtration and filtration occurs in the glomeruli, which is reflected by a significant increase in the glomerular filtration rate.

2. Silent stage

The filtration rate can be normal and normal, or high, but early symptoms of kidney damage begin to appear.

3. Primary clinical stage of diabetic nephropathy

This stage is characterized by the appearance of a small amount of albumin in the urine (Microalbuminuria), as the daily excretion of protein albumin in the urine in an amount ranging between 30-300 milligrams.

This increase in the amount of protein in the urine is predictive of continued progression and exacerbation of kidney damage, especially in patients with type 1 diabetes , and of a very increased risk of cardiovascular complications in those with both types of diabetes.

Early and intensive treatment at this stage may be able to prevent or slow the progression and exacerbation of diabetic nephropathy.

4. Fourth stage

A relatively high percentage of patients progress from the previous stage to this stage in which kidney disease is evident.

At this stage, more than 300 milligrams of albumin is excreted in the urine per day, in addition to this, the following symptoms appear: Decreased glomerular filtration rate, high blood pressure (Hypertension) and significant changes in the kidneys that appear when examined under a microscope.

These symptoms appear in approximately 35% of patients who developed diabetes 15-25 years ago.

5. The final stage

The majority of patients progress from the case of obvious kidney disease to the final stage of advanced and final kidney failure, and they need dialysis treatment about 25-30 years after their diagnosis of diabetes.

Symptoms of diabetic nephropathy

Symptoms of diabetic nephropathy are as follows:

• Uncontrolled blood pressure.
• Urgent need to urinate.
• The presence of protein in the urine.
• difficulty concentrating
• shortness of breath.
• Constant itching.
• Anorexia.
• Nausea and vomiting.

Causes and risk factors for diabetic nephropathy

Diabetic nephropathy occurs when the blood sugar becomes uneven, causing damage to the blood vessels in the kidneys, impairing kidney function.

risk factors

Factors that influence the development of kidney disease include:

• Diabetes.
• Hypertension.
• smoking.
• History of the disease in the family.
• Fats in the blood.
• The patient’s age and gender.

Complications of diabetic nephropathy

Complications of diabetic nephropathy:

• fluid retention;
• sores on the feet;
• Damage to the blood vessels in the cornea.
• High level of potassium in the blood.
• Complications during pregnancy.
• heart disease;

Diagnosing diabetic nephropathy

To diagnose diabetic nephropathy, the doctor orders the following tests:

• A urine test, to check for protein in the urine.
• CT scan.
• Kidney function check.
• Kidney biopsy.

Diabetic nephropathy treatment

Patients are treated according to their health conditions.

1. Primary diabetic nephropathy treatment

The causes are treated as follows:

• Treating high blood pressure.
• Treating high blood sugar.
• Control the presence of protein in the urine.

2. Treatment of advanced nephropathy

In cases of non-response to previous treatments, treatment is carried out as follows:

• Dialysis.
• Kidney transplant.

Prevention of diabetic nephropathy

Among the ways to prevent and protect against diabetic nephropathy:

• Controlling blood sugar level.
• Treating high blood pressure.
• Quit Smoking.
• Maintain a healthy weight.

source : wikipedia

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