Diabetic Nephropathy

Diabetic kidney disease (diabetic nephropathy) is common in long standing diabetics especially in those with poor control of the condition. Diabetes damages blood vessels throughout the body and this includes the kidney. Diabetic nephropathy occurs in both types of diabetes – the insulin requiring (type I) and the non-insulin requiring (type II) diabetics. The occurrence of high blood pressure in diabetics is a strong predictor for diabetic nephropathy. For those with existing diabetic nephropathy, uncontrolled blood pressure will aggravate and hasten the progression of this disease to end-stage kidney failure. Those who have a family history (having family members with this condition) are at higher risk of being afflicted with this condition. It is the most common cause of End-Stage Renal Disease (ESRD) in many developed countries (and is true in Singapore as well).

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Signs and Symptoms

  • High blood pressure / Hypertension
  • Lethargy
  • Leg swelling (worse after walking/standing)

  • Itching
  • Nausea and/or vomiting
  • Frothy urine (signifying protein in urine)

  • Losing weight
  • Increased need to urinate
  • Protein in urine (as determined by urine dipstick or other urine tests)

Treatment

  • Good control of diabetes (good control of blood sugar levels)
  • Good control of blood pressure (aiming for <130/85 or lower in younger patients)
  • Medications may be given by your doctor to decrease protein excretion and preserve the function of kidneys
  • May be advised to take lower protein diet by your doctor
  • Treat any Urine Tract Infection (which is common in diabetics)
  • It is very essential to see your doctor regularly if you already have the disease and comply with all treatment prescribed
  • Requiring less pills or insulin to control diabetes treatment

Prevention

One may be able to prevent getting diabetes by:

  • Maintaining ideal body weight
  • Regular exercise
  • Proper nutrition (right amount of total calories and carbohydrate)

 

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If you already suffer from diabetes and want to prevent serious diabetic kidney disease:

  • Be serious about maintaining good sugar control
  • Get treated for high blood pressure/hypertension, if present
  • Have your urine checked regularly for protein
  • You may require specialised tests (urine, blood, or radiological) from time to time.

Do not wait for symptoms to appear, go for regular health check-ups!