Diabetes is a lifestyle disease that is very prevalent in the current generation. According to a report by the World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% to 8.5% from 1980 to 2014. Diabetes should not be taken lightly as it can affect other body organs besides the pancreas, such as the kidneys. Diabetic nephropathy refers to damage to your kidneys caused by diabetes, and may also lead to kidney failure in various cases.

Causes of diabetic nephropathy
Not everyone who suffers from diabetes will suffer from diabetic nephropathy. The main function of the kidneys is to filter waste from your blood. However, this is not always the case. Due to high a concentration of blood sugar caused by diabetes, several blood vessels in the kidney are destroyed, thereby, preventing the kidneys from carrying out its job. Over time, the kidneys may stop working altogether, resulting in kidney failure. If you are diabetic, the probability of you suffering from diabetic nephropathy will increase if you smoke or have high blood pressure or high cholesterol.

Catching it early
Today, diabetic nephropathy is the leading cause of chronic kidney disease in the US and other western countries. Since the symptoms of this condition aren t visible in its early stages, you need to undergo urine tests on a regular basis. If detected early, the effects of diabetic nephropathy can be reversed. Common symptoms of this disease include the following:

Swelling in legs and feet
Detection of albumin in urine
Decline in glomerular filtration rate (GFR)
Elevated arterial blood pressure
What are the treatment options?
Medication to lower the blood pressure is the most commonly prescribed form of treatment suggested by doctors to prevent or slow the damage to your kidneys. There are other lifestyle changes that you may have to undertake in order to keep a check on the condition:

Limit sugar intake and keep blood sugar levels within the target range
Exercise regularly and work towards keeping your heart healthy
Limit protein intake, as it could put extra pressure on your kidneys
Limit salt intake to control blood pressure
Quit smoking and drinking
Diabetes is an unfortunate condition to have to live with. But don t let it bog you down! With these simple lifestyle changes and taking care of your general well-being, you can beat the disease and emerge a winner!

Diabetic Nephropathy - Who is at Risk of Acquiring it?

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?

The kidneys are the main excretory organs and remove all toxins and wastes from the body in a liquid medium, the urine. The urine is normally straw coloured as there are filters which do not allow blood to enter the kidneys. However, due to various reasons, when there is a disease in the urinary tract, red blood cells can escape into the urine. The urine then assumes a pinkish tinge; the exact colour would depend on the amount of blood leaked. While the thought of pinkish urine is scary, it becomes a bigger concern when seen in children. Read on to know a little more about the types, causes, and ways to manage this condition. 

Types: 

Microscopic: When there is blood visible only through a microscope. This is quite common in children, and unless there is no accompanying kidney disease, it does not pose a problem when found occasionally. 
Gross: It is when the color of the urine changes to a pinkish tinge. This is of concern and requires immediate attention. 
Causes: 

There are various reasons and some of them are listed below 

Inherited causes: Conditions like sickle cell disease, polycystic kidney disease, Kidney stones and inherited nephritis. 
Structural causes: Cysts in the kidneys can cause hematuria 
Trauma: An injury (to the abdominal area) during sports should be ruled out, which could have damaged the problem 
Infections: Infections along the entire urinary tract right from glomerulonephritis to kidneys to bladder can cause blood in the urine 5.   Imbalances in minerals: High levels of serum calcium, which puts them at a higher risk of developing kidney stones later. Dietary calcium should be reduced. These children also could have a history of stones in the family. 
Idiopathic: When the cause of the hematuria is not known, it is termed idiopathic. 
Associated issues/Diagnosis: 

Hematuria is an indication or a symptom of an underlying medical condition (be it infection or trauma) and the underlying cause always needs complete evaluation. Accompanying symptoms can help narrow down the diagnosis. If any inherited cause is suspected, presence of hematuria should always be assessed in parents and grandparents. 

Check for history of trauma 
Known prior kidney disease 
Symptoms of infection 

Family medical history 
Urine tests to analyse its composition 
Urine culture, MRI, CT scanning, or biopsy may be required in more serious cases. 
When to worry? 

Associated proteinuria 
Microscopic hematuria which is persistent 
Kids with high blood pressure 
Kids with other existing kidney diseases 
Management: 

In most cases, no specific treatment for hematuria is required as the condition subsides after the underlying problem is addressed. For instance, once the infection clears, the hematuria also clears. Follow-up urine tests may be required to confirm that it is cleared. Blood in urine must always be evaluated by pediatric nephrologist as its causes range from very mild disease to rapidly evolving kidney failure, which may occur over days to weeks.

Blood In Urine In Kids - Know The Reasons Behind It!

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

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

People with chronic kidney disease notice that their bones tend to get weaker and more slender. They become painful and are bound to break more easily as a consequence of mineral loss. The most common kind of bone infections happen when:

There is a change in the balance between two essential minerals in your body - calcium and phosphate, which prompts loss of calcium from your bones.
Four small glands (parathyroid organs), which regulate calcium in your body, turn out to be excessively active.
There is a change in the way your body utilizes vitamin D, a mineral that is vital for healthy bones.
Every bone disease affects bones in different ways.

Phosphate is found in many food items you eat. Your kidneys normally eject whatever is not required in the body. At the point when your kidneys have stopped functioning properly, phosphate may develop in your blood. Excess phosphate in your blood prompts loss of calcium from your bones, which has a tendency to weaken them. Eating food items that are low in phosphate can keep phosphate from building up in your blood.
Since phosphate stays in your body when your kidneys are no more ready to remove it, four small glands in your neck (parathyroid organs) turn out to be excessively active. When this happens, calcium is expelled from your bones over a long period of time, making them weak.
Vitamin D is a vital vitamin, which affects the balance in the calcium content of your body. Typically, vitamin D is processed into a more soluble state by the kidneys and can be utilized by the body. In case your kidneys have deteriorated, they can no more do this critical job. Luckily, the dynamic type of vitamin D is accessible in the form of medications that can be prescribed by your specialist, if necessary. In case you have a kidney disease, it is vital to find a way to prevent bone illness. Some of the solutions are as follows:
Limit the amount of phosphorus you take in every day. Ask your specialist or dietitian to let you know how much phosphorus you need to have. You can likewise request a list of high-phosphorus food items.
Take a phosphate folio. This is a medicine that you bring with dinners to keep your body from taking in the phosphorus that originates from your food and beverages. This can keep phosphorus from winding up in your blood.
Take a calcitriol supplement. Your kidneys make calcitriol with the help of vitamin D that you get from food and the sun. When your kidneys are not working, they can't make calcitriol. A man-made type of calcitriol can help your body utilize the calcium and phosphorus it needs.
Exercise can make your bones more strong and keep them from breaking.
Try not to smoke or use tobacco. It can aggravate bone disease.
Take your medications the way your specialist instructs you to and do not skip dialysis medicines.
Even after changing your diet and taking medicines, if you still have an excess of phosphorus in your blood, your specialist may propose that you undergo further dialysis.

Kidney Disease - How It Affects Your Bones?

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