What is Diabetic Nephropathy?

Diabetic nephropathy (Diabetic Kidney Disease) is defined as the progressive damage to the kidneys caused by diabetes. It is characterised by the scarring of the glomeruli in the kidneys due to prolonged diabetes mellitus.

What Causes Diabetic Nephropathy?

Diabetes is a condition characterized by high concentration of blood sugar. Although the cause of Diabetes Nephropathy is not yet well defined, it is likely that the high sugar levels in the blood damage the blood vessels present in the kidneys that help to filter waste products, thus resulting in decreased kidney function and ultimately, kidney failure.

Not everyone with diabetes suffers from diabetic nephropathy. Although, factors that can increase your chances of getting diabetic neuropathy are-

Smoking

Poor control of blood glucose

High blood pressure

History of kidney diseases

What are the symptoms of diabetic nephropathy?

In the early stages, there may be no symptoms at all, but as the disease progresses, you may notice swelling in the extremities like your feet. Thus it is recommended to get your blood albumin levels tested on a regular basis. If it is diagnosed in early stages, the damage can be reversed. Other symptoms that can indicate damage to the kidneys are-

Severe malaise

Headaches

Nausea

Lack of appetite

Frequent voiding

Itchiness of skin

General feeling of illness

Diagnostic tests that can confirm diabetic nephropathy are-

Routine urine test (urinalysis) - Kidney diseases are detected by the presence of a protein in the urine called albumin and this condition is called albuminuria. Other parameters that must be regularly monitored are-

Blood pressure

Cholesterol levels in your blood

How can you treat/ manage diabetic nephropathy?

If this type of nephropathy is diagnosed in the early stages, the damage to the kidneys can be reversible. The key to managing diabetic nephropathy are-

Diet: Reduce the dietary intake of salt, phosphorous and potassium in the advanced stages.

Glycemic Control: Monitor your blood glucose levels regularly

Management of Hypertension: It is important to manage your blood pressure as it can have a direct effect on the coronary blood vessels which in turn pump blood to the various blood vessels of the body

Renal Replacement Therapy: In chronically ill patients, renal replacement therapy is the best option. This can include haemodialysis (a procedure to flush out toxins from the blood, such as urea), peritoneal dialysis or ultimately renal transplantation.

Diabetic Nephropathy - Causes, Symptoms and Treatments

A lot of bad things can and do happen when the kidneys fail.  The kidneys are vital for proper bodily functioning because they filter liquid and solid waste products out of the blood and allow vital chemicals (which the body needs for functioning) to flow into the body through the bloodstream.  People can become very sick when the kidneys either fail to perform these functions or fail to perform them properly.  Many people will get chronic kidney disease, therefore, they need to know what the causes and symptoms are in order to treat, and even prevent these diseases from occurring.

People who suddenly experience the following symptoms should see a nephrologist as soon as possible for a medical examination:  blood or protein in the urine, kidney stones, acute kidney injury, kidney infections, and/or pain, and Hepatitis C and kidney disease.  

Blood in the urine can be a sign of kidney problems which can lead to kidney disease.  Additionally, people who urinate frothy or bubbly urine, or have swelling in the hands, face, and feet should see a doctor because this is a sign of protein in the urine.  Protein in the urine can be detected by a urine test.  Kidney stones can be very painful and are problematic.  They are caused by mineral buildup in the kidneys.  Men and white people tend to get kidney stones more, and they can cause blood in the urine, painful urination, sharp lower abdominal or back pain, and nausea and vomiting.

Acute kidney injury occurs when the kidneys stop functioning altogether in a short period of time.  Because this disease can be deadly, those with this disease should get immediate medical help.  Usually, the very sick patients in hospitals get this disease, but it can also be caused by certain medicines, injury, or infections.  This type of kidney disease is easily reversible.  

Symptoms include

Not passing enough urine when urinating
Leg, ankle, or feet swelling
Fatigue
Breathing problems
Confusion
Nausea, and chest pressure or pain. 
Kidney infections tend to be caused by bacteria that have spread from the urinary tract.  Women, because of their anatomy, tend to get kidney infections more than men. 

Symptoms include:

Fever
Vomiting
Back, side or groin pain
Chills
Nausea
Frequent urination
Frequent urges to urinate
Painful or burning urination
Pus or blood in the urine
Cloudy or foul-smelling urine
Kidney pain in the lower back or sides can signify more serious kidney problems.  They can be caused by urinary tract infections, polycystic kidney disease, kidney infections, blood clots, and/or bleeding in the kidneys.  
Hepatitis C is a disease that attacks the liver and can cause kidney disease.  

Symptoms include

Loss of appetite
Nausea
Fever
Fatigue
Vomiting
Dark colored urine
Grey colored stool
Joint pain
Yellow skin and eyes
While kidney diseases are at best unpleasant, and at worst, life-threatening, they can be avoided by drinking lots of water, eating a healthy low salt diet, and watching for any changes in health and urine over time.



What Happens When Kidneys Fail & Signs That Indicate It

There can be no better way to maintain a healthy lifestyle other than a regular exercise and fitness routine. Sometimes even after surgeries, doctors recommend exercise to the patients for a speedy recovery. A kidney transplant is one such surgery that requires you to follow a strict fitness regime after the operation process.

Importance of Exercise after a Kidney Transplant:

Exercise, as recommended by the doctor, should be an integral part of the lives of kidney transplant patients. The variations of exercise may differ depending on the age and general physical health of the patient. The need for exercise after a transplant is as follows  

  Helps to increase energy levels
  Increases overall physical strength and immunity
  Helps maintain a standard weight as an obese body is very harmful for patients suffering from kidney ailments
  Reduces stress, anxiety and depression
  Prevents after effects of kidney transplant like high blood pressure and cholesterol level
  Helps to strengthen bones
  Helps tone muscles and increases balance and joint flexibility
  Strengthens the heart and overall cardiovascular system
  Helps the patient to sleep better
  Boosts self-image and increases confidence

Types of Exercises that can be done:

  Stretching   Consistent stretching before any exercise helps increase muscle strength. It also prevents muscle strain and injury.
  Aerobic   Aerobic or cardiovascular exercises are generally recommended for younger patients. It includes moderately heavy exercises involving a greater number of muscles. This kind of exercise strengthens the heart and lungs and improves breathing. Aerobic exercises include walking, jogging, jumping rope, bicycling, skating, rowing and water aerobics. However, for most patients, brisk walking or jogging is recommended.
Ideally one should exercise for a minimum period of 20 minutes at least four times a week.

Things to Remember:

  It has been medically proved that patients who exercise regularly following a kidney transplant procedure are more likely to survive healthily for the upcoming 5 years compared to patients who lead a sedentary life.
  However one should not resort to heavy and strenuous exercises immediately after the surgery. It is advisable to start with mild forms of exercise like walking and increase the levels gradually depending on one s age.
  One should not eat a heavy meal just before exercising.
  It is important to stop for breaks in between exercise. The patient should not over exert himself.
  It is advisable to avoid lifting heavy weights like dumbbells.
  Stop exercising immediately if you experience chest pain, lightheadedness or pressure in chest, neck or arm.
  Consult the doctor for the kinds of exercises you can do depending on your condition.

With a healthy diet and regular exercise, there are fewer chances of reoccurrence of kidney ailments.

Fitness/Exercise/Games After Kidney Transplant!

A kidney stone may not be as big as the stones in your garden, but can be quite a pain. Kidney stones are actually mineral crystals that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball. While some kidney stones pass out of the body along with urine, others can block the urethra and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
 
Not all kidney stones need to be treated with surgery. If the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 

Larger kidney stones may need you to be hospitalized for treatment. These are:
- extracorporeal shock wave lithotripsy (eswl)
To begin this of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed through the kidney stone to break it into smaller pieces, which can then pass out of the body through urine.
- ureteroscopy
This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 
- percutaneous nephrolithotomy (pcnl)
This surgery is performed under general anesthesia. It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 

- open surgery
Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone.

Kidney Stones- Should It Be Removed

Kidney stones could be a cause for worry by the time they are not removed causing incessant and regular pains and disrupting normal life. The task is not finished even if you get them removed because what follows is a rigorous and disciplined routine that you must follow to maintain your health after the surgery is done. Diet plays a crucial role in negating the possibility of yet another stone accumulation. Here are a few diet tips that would be handy if you have got a kidney stones removal surgery done. 
 
Do's
1. To stay hydrated is the golden rule that you must abide by at all costs. It is advisable to drink at least 2-3 litres of water on a daily basis. Water prevents the formation of stones and would also help to eliminate any remaining residues of kidney stones existing in the system. 
 
2. Dairy products could be included but in diluted form. 
 
3. A fixed dietary routine is mandatory above all. The patient should be given meals at proper time intervals in small proportions. Heavy meals should be avoided at all costs. 
 
4. Foods rich in high fibre should be included in the diet. They help in bowel movement also. These include whole grain breads and beans. 
 
Don'ts
 1. Foods rich in oxalates and calcium should be kept at bay for at least a period of two months after the stone removal procedure is complete. Oxalates can lead to the formation of yet another stone which is far from desirable. The foods that fall in this category include:
-Green leafy vegetables like spinach, mustard and beet greens
-Cabbage, cauliflower, tomatoes
-Banana, mango, apricot, grapes
-Nuts like almond and cashew
-Alcohol
-Soft drinks
-Soda
-Caffeinated drinks like tea and coffee
 
2. Foods rich in sodium should be kept at bay for at least some time immediately after the surgery. 
 
3. Reducing the food intake that is high on animal protein. 
 
4. Do not eat stale food. 

5. Junk food should not even cross your mind. It is something which should be avoided for best results. 
 
These are generic guidelines that would help you to cope with post surgery care. However, there could be specific requirements depending from patient to patient. Therefore, it is advisable to get the guidelines by a doctor who will take into account the specificities of the case. Diet along with exercise is in most cases, the most effective combat to kidney stones. The trick however, is to not go overboard with either of them.

Diet Plan Tips After Kidney Stones Surgery - Eating Guidelines

Every organ is important for the human body to perform its functions normally. Kidneys too are vital and are responsible for removing the excess fluid and toxins from the body. If the kidney is not functioning properly, then the patient is advised to undergo dialysis treatment. In some cases, the patient is advised to undergo a transplant. However, in any case, the patient has to follow a healthy diet, for the treatment and the medicines to work positively.

Suitable diet during dialysis
Most of the patients are not aware of the diet prescribed for dialysis. Though it is always advised to consult a dietician before following any diet for the condition, it is also advisable to gain some knowledge about what the dietician might suggest, so that one is not clueless about the treatment. In a majority of the cases, food containing potassium, phosphorus, low-fat cholesterol, and sodium is included in the diet of these patients. However, these are prescribed in a limited amount and vary from patient to patient.

Sodium: The sodium level of the dialysis patients needs to be controlled; and this can be done by eating food items that have a low sodium content, not more than 2,000 mg. Hence, the quantity of snacks, pudding, and chips are to be reduced in the diet chart.
Potassium: The level of potassium also needs to be kept in check to avoid further deterioration of the kidney. Bread, certain vegetables, and grains contain a high amount of potassium. Moreover, various salt substitutes contain potassium chloride instead of sodium chloride. Large intake of these foods may affect the kidney permanently. Hence, these are majorly excluded from the diet. The patients are advised to include tomatoes and bananas in their diet, though not on a daily basis.
Phosphorus: The patient is advised to avoid foods with high phosphorus. This includes milk and dairy products and grains. However, while on dialysis, meat is important as it gives enough protein despite being high on phosphorus. But, an abundance of meat in the diet may affect adversely. Hence, this is advised, but kept in control.
Cholesterol: To keep cholesterol amount in check during dialysis, the patient needs to cut down on fruits and vegetables and specific fat diets, while eating a sufficient amount of fish.
Protein: High protein food is necessary for a patient with a kidney disease. Meat is an excellent source of protein. Along with that, poultry, fish, and eggs are important, as well. Hence, all this is included in the diet.
Fluids: Dialysis helps in removing the excessive waste fluids from the kidney. But, to keep the body hydrated, the patient is allowed liquid intake, but only up to a certain limit.
It is necessary to maintain a proper diet during dialysis, as it quickens the treatment as well as helps the patient recover quickly.

Undergoing Dialysis - What Should Be Your Diet?

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