Nephropathy is also known as renal disease. It is any type of damage or disease relating to the kidneys. Though not everyone with diabetes has nephropathy, however, diabetic nephropathy can cause kidney failure.

How does diabetes affect the kidney?
Kidneys are responsible for taking waste out from your blood. They have a lot of tiny blood vessels to do this. High blood sugar may kill such blood vessels. Once these blood vessels are destroyed, the kidneys may not function as well or it may even lead to kidney failure.

What increases your risk of getting diabetic nephropathy?
There are several factors which increase your risk of getting diabetic nephropathy including: \
1. High blood pressure
2. High cholesterol
3. Smoking
4. Being native american, african american or of hispanic origin, for whom risk factors have proved to be magnified
5. If you have family history of diabetic nephropathy

Symptoms and diagnosis:
There are very few noticeable symptoms, which appear when you have diabetic nephropathy, except swelling in your arms and legs. The diagnosis is done by checking for a type of protein in your urine known as albumin, which is not supposed to be there. Getting the diagnosis done early is crucial.

Preventive measures
You can prevent kidney damage by doing the following:
1. Keeping your blood sugar levels under control - keep hba1c &lt; 6-7%
2. Keeping your blood pressure under control in the range of 130/80
3. Eating healthy food
4. Exercising regularly
5. Not eating too much protein
6. Not eating too much salt
7. Reducing smoke or excessive tobacco usage

Medicines for treatment
If you do get diabetic nephropathy, here are some medicines, which can help cure it
1. Ace inhibitors which are also called angiotensin-converting enzyme inhibitors
2. Angiotensin ii receptor blockers (arbs)

Possible complications
1. Blood pressure may rise
2. Triglyceride levels and cholesterol levels may rise.

All About Diabetic Nephropathy

Needless to say, your kidneys play an incredibly important role in filtering waste from your blood, and therefore maintain healthy functioning of the body. Blood pressure, production of red blood cells, and electrolyte balance, all of these are regulated by the proper functioning of the kidneys. Kidney failure causes too much build-up of waste nitrogen products,acids and/or excess fluid,which causes major cardio respiratory problem to the patient.
Symptoms-

Shortness of breath 
A reduced amount of urine
Swelling of your legs, ankles, and feet
Excessive drowsiness or fatigue  
Confusion
persistent nausea
Pain or pressure in your chest
Seizures
Coma 
Inability to properly remove potassium that runs in the bloodstream can lead to irregular heartbeat and ultimately, death that is sudden and unforeseen.

How can it be treated?
The causes of kidney failures are many and the key to treat them is to correct the underlying cause first. Chronic kidney disease, however, has no cure. Treatment generally comprises measures that aid in controlling symptoms and signs, reduce complications, and slow down the progression of this disease. Despite efforts to treat the cause, the condition might keep worsening and there is little to guarantee the fact that complications will not arise. This is precisely why it is of utmost importance to opt for examinations at regular intervals so that you may ascertain if your disease has remained stable or worsened.

End-stage of Kidney disease 
In the case that your kidneys are unable to keep up with fluid and waste clearance as is normally expected, then there s a good chance that you have developed a near-complete or complete case of kidney-failure, and are afflicted by end-stage kidney disease. If this is indeed the case, then you have two options to resort to:

Dialysis: This helps remove the extra waste products that the kidneys fail to do. In haemodialysis, fluid and waste filtering takes place with the aid of a machine that drives these excesses from the blood. In peritoneal dialysis, catheters are employed to rid the body of the accumulated waste products.
Transplant: Kidney transplants involve a surgical placement of a healthy kidney in your system from a compatible donor, either living or dead. Medications will be a necessity since the body has to be prevented from rejecting this new organ.
You may also opt for treating the condition with conservative measures in case you don t want to resort to the aforementioned procedures.

Kidney Failure - What Should You Know About it?

Often, early stages of kidney diseases do not come with specific signs and symptoms and most people will remain unaware of their condition. However, certain symptoms may be perceived that may indicate that a person is suffering from early stages of kidney failure. When you are diagnosed with kidney failure (also known as renal failure) in the initial stages, certain measures can be taken to retard the progression of the renal disease. This can also help reverse the condition and improve the quality of life of the patient. On the basis of a typical cause, the symptoms of kidney failure are grouped into specific categories that are given below. If you notice any of the specified renal failure symptoms, it is recommended to immediately fix up an appointment with your doctor and get your diagnostic tests done. 

Symptoms of Renal Failure from the accumulation of waste products in the body: 

Metallic taste in mouth 
Nausea and vomiting 
Facing difficulty in concentrating 
Loss of appetite 
Aversion towards meat (protein aversion) 
Itching or pruritus 
Symptoms of Renal Failure from the accumulation of fluid in the body: 

Dyspnoea or shortness of breath (this happens due to the accumulation of fluid in the lungs).
Swelling is seen in the feet, hands or face. 
Symptoms of Kidney Failure from damage to the kidneys: 

The amount of urine production changes, though it is not a reliable sign Haematuria or blood in the urine (usually in microscopic quantity). 
Frothiness or foam in the urine (usually happens when protein is present in the urine). 
Symptoms of Kidney Failure due to decreased blood production (anemia): 

Dyspnoea or shortness of breath. 
Fatigue Weakness. 
Confusion If you happen to feel cold all the time. 
The following diagnostic tests will be performed by your doctor in order to determine whether the symptoms are the manifestation of a kidney failure or not: 

Urine analysis - In this test, a sample of your urine is tested to find traces of blood, white blood cells or proteins which may indicate a problem in kidney function. 
Blood Tests - This includes tests for BUN and creatinine in the blood which are usually removed from the blood if the kidneys function properly. 
Actions must be taken when you show signs and symptoms of kidney failure: 

It is common that the symptoms of early renal failure are not always prominent, but if any of the above symptoms are witnessed, it is recommended to met a physician to determine whether they are caused by a kidney disease. You can pen-down the symptoms that you feel are related and bring it to the doctor when you fix up the next appointment. It is essential to know about your disease at the earliest as it will give you time and the ease of taking measures to retard the damage process and will decrease or delay the probability of undergoing dialysis or kidney transplant.

The kidneys are the purifiers of the body; they help in removing the waste from the body through the urine. In those suffering from kidney diseases, the function of the kidney is affected, and so their ability to clear out waste from the body is reduced and completely lost gradually. However, waste continues to form, and therefore, such patients have to undergo dialysis, where the blood is purified through an external device.

The frequency and duration of the dialysis would depend on how effectively the kidneys are still functioning and how much waste has been formed from the time of the previous dialysis session. The person s overall body mass index (BMI) and the water weight gained are also considered.

Once it is decided that a person s kidneys are damaged and dialysis is required, the person has to prepare for a long-term process. The following outlines what to expect before, during, and after the dialysis sessions. 

Before the session: 

Since most people prefer to get it done at a dialysis centre, it is preferable to plan for it, three treatments a week on an average, with each session lasting about 4 to 4 hours.

During the session: 

The blood flows through the dialysis device, which acts as an artificial kidney. The sequence of events are as follows:
The Weight is checked
Vital signs, including heart rate, blood pressure, breathing and pulse are checked.
The access areas are washed, and needles are used to connect these areas to the dialysis machine. Anesthesia may be used in the beginning to reduce the pain in this area.
The same access areas are used for each session, and over a period of time, buttonholes are formed which is like a small tunnel.
Though the session would last about 3 to 4 days, normal activities can be done, including reading, working on a laptop, watching television, or even sleeping.
Once the dialysis session is complete, the tube will be removed and a dressing is placed over the site.
After the session

The same site is used each time for the dialysis, so for the first couple of sessions, there could be discomfort. There could also be nausea, diarrhoea, cramping, and headaches.
The treatment needs to be adjusted based on symptoms, so please let the doctor know if you experience any symptoms.

Call the doctor if you are facing the following:

Bleeding from the access site
Inflammatory signs around the site
Persistent fever of over 104 degrees
Numbness or weakness in the arms
Confusion, drowsiness, or cognition problems
Though initially uncomfortable, once you get into the dialysis schedule, you will notice the difference of how cleansed you will feel after each session.

Undergoing Dialysis - What To Expect From It?

A dialysis diet is a special diet that is customized for patients who are or will be starting dialysis within a short period of time. Such a diet is prepared to reduce the waste and fluid levels that keep on accumulating between the dialysis sessions so that the patient remains healthy for the process to be carried out seamlessly.

What can you eat?
Eat foods which are rich in high-quality proteins (poultry, fish, lean meat and egg whites).

What can t you eat?
Eat less of foods which are rich in sodium and phosphorus.

Foods high in Sodium
1. Use minimum salt in preparing the dishes; this helps control BP and probable weight gain that might happen between the dialysis sessions.
2. Make use of spices, herbs and other salt-flavored enhancers.

Meat
1. Patients on dialysis need to include more of high-quality protein foods in their diet. This will help regulate blood protein levels. Eat about 10 ounces of foods rich in high-quality protein every day.
2. 1 egg,   cup of ricotta cheese,   cup of tuna.

Salads/Vegetables

The potassium content of vegetables can be alarming for a patient on dialysis. Eat 3 servings of vegetables that are low in potassium every day. These include broccoli, cauliflower, cabbage, carrots, garlic, cucumber, eggplant, celery, radishes, etc.
Avoid vegetables such as beets, potatoes (in any form- wafers or wedges), winter squash, cooked spinach, pumpkin, asparagus and avocado.
Note:

Although seeds, nuts, peanut butter, lentils, dried beans and peas are rich in protein, they are generally struck off from the diet plan because of their high phosphorus and potassium content.
You can have moderate amounts of grains, bread and cereals.
Try and not have brown bread and other whole grains as they are loaded with phosphorus.
Usually, 5-10 servings of these are considered sufficient for patients on dialysis.
Also, limit intake of milk and other dairy products.
  cup yoghurt or   a cup of milk is considered safe. Also, remember that all varieties of milk- skim, whole and low fat, have the same amount of phosphorus.
All fruits contain some amount of potassium. However, some of them contain more potassium than the others. Limit your intake of fruit juices.
Avoid or limit fruits like: 
Orange juice and oranges
Kiwis
Prune juice and prunes
Dried fruit and raisins
Melons
Bananas

Dialysis - What To Eat & What To Avoid?

Acute kidney failure is the kidney's inability to filter waste from the blood. As soon as the kidney loses the filtering ability, a humungous amount of body waste gets accumulated in the kidney and the chemical makeup of the body goes out of balance. Kidney or renal failure can progress tremendously from hours to days. This is a condition that is mostly witnessed in critical patients who are already hospitalized. This condition can prove to be fatal but can be reversed with treatment and medication. Here is a list of things one should do whilst suffer from kidney failure:

Lifestyle and dietary adjustments
During the phase of recovery, the medical team might assist a patient to go a special diet and limit the activity of the kidney so that they get the required time to heal. A nephrologist often routes this cases to a dietician or carefully analyses the present diet to lock up on the diet required for a speedy recovery:
Lower amount of potassium in food: Food with low potassium content is often recommended by the doctor. It ensures that kidney does not stress itself. Foods to avoid include spinach, bananas, oranges, tomato and potato. Some of the foods that need to be included in the diet are cabbage, strawberries, apples and grapes. Furthermore, food must be consumed in small quantities but in multiple servings.
Limit the amount of phosphorus in food: Phosphorus is found in abundant quantities in food items such as peanut butter, milk, dried beans, cheese and nuts. Along with skin itchiness, phosphorus can weaken the bone as well. A dietitian might share special instructions on how to cut down the amount of phosphorus and the substitute food to counter the effect of the above-mentioned ones.
Avoid salty products: It is extremely necessary to cut down food items that contain an excess amount of salt in it. Food products such as the canned soup, frozen dinner, and fast food are the major culprits in worsening the condition. Processed meats and cheese are equally bad.

Preventive measures to avoid kidney failure:

OTC pain medications: It is necessary to check the label of over the counter pain medications. Consumption of too many OTC medications can result in kidney failure. A pre-existing kidney condition can further aggravate this condition.
A healthy lifestyle: A sensible lifestyle with simple diet can do wonders for a kidney to be healthy in the long-term. Some of the other things to keep in mind include doing regular exercise, refrain from alcohol or drug abuse and remain active throughout the day.
Consult a doctor: Even a hint of a kidney problem should be discussed with a doctor to ensure that even the smallest of problems can be addressed at the earliest. 

Acute Kidney Failure - What Should You Do In Such A Case?

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