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?

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

When do kidneys need dialysis?

Kidneys are a pair of organs that are located on either side of the spine, each about a size of a fist. The kidneys help in purifying blood by removing toxins, waste materials and excess fluids from the human body. Disorders and dysfunctions of the kidney can lead to severe and often fatal consequences. When the kidneys stop functioning as they are supposed to, dialysis is performed to resume normal functioning in the body.

Dialysis is a type of treatment, which filters and purifies the blood with the aid of a machine. It is an artificial way of purifying blood. There are two types of dialysis, namely hemodialysis and peritoneal dialysis. Hemodialysis, the most common form of dialysis, which involves using a manmade kidney called a hemodialyzer, which removes toxins and waste materials from blood.

Peritoneal Dialysis, on the other hand, is a type of treatment which involves implanting a catheter in the stomach. During the procedure, a fluid called dialysate flows into the abdomen that absorbs all the waste material, which is consequently drained out of the body.

You may need a dialysis if:

- Your kidneys are dysfunctional
- When waste materials and toxins start to accumulate in the body
- In an event of an injury or accident to the kidney such as internal lacerations (wound caused by the tearing of a tissue)
- If the creatinine (a type of a chemical waste product) level falls to 10-12 cc/minute
- In an event where the kidneys aren't able to work properly leading to accumulation of toxins, irregular amounts of chemicals in the body and other dysfunctions

Weakening of the abdominal muscles and weight gain are some of the risks involved in dialysis. Dialysis is a temporary treatment and serves to function till the time the actual kidneys get repaired. In chronic cases of kidney disease, kidney transplant may perhaps be the last resort.



When Do Kidneys Need Dialysis?

One of the most significant glands in the male reproductive system is the prostate gland, which is responsible for carrying urine from the bladder. It is located right under the bladder and helps in production of semen which contains sperm.
Prostate cancer is a slow growing form of cancer that is rarely seen in men below the age of 50. It may occur due to both, genetic and environmental factors. Here is a list of measures that can help in preventing this ailment.
Food Intake and Weight: Apart from age, the major factor that contributes to the risk of prostate cancer includes food and weight. Doctors suggest that bringing down your intake of calcium and fat that comes from red meat and excess dairy can help in preventing the onset of this ailment. The calcium intake should not go beyond 1,500 mg per day, which is why doctors will usually ask you not to have supplements. Cooked tomatoes with olive oil as well as cruciferous vegetables including broccoli and cauliflower should be included as a vital part of one's diet, while fish should be taken regularly as it is a source of healthy or good fat like Omega-3 fatty acids. In general, you should have fewer calories which should be matched up with ample exercise so that a healthy weight and balance is maintained.
Stress and Blood Pressure: Stress and anxiety are also major reasons that contribute to the onset of this disease. One will need to see a doctor about high blood pressure, especially the kind that is triggered by stress and causes hypertension. Also, you must control your cholesterol and stay out of depression to ensure that your risk of developing prostate cancer reduces. Also, having these conditions along with prostate cancer makes the survival chances that much lower. So, you must get the right medication and treatment for these conditions as well.
Lifestyle: One will need to quit smoking, that can cause a number of ailments including prostate cancer. Also, drinking alcohol in moderation is required in order to have a healthier lifestyle and cut the chances of developing such ailments.
Screening: While your diet and other aspects may be right, there is still a great chance of developing prostate cancer, especially if anyone in your family has been afflicted with this condition in the past. Therefore, it is recommended to get an annual screening done so that you eliminate the chances of finding it out late, and can check the growth of any anomalies as soon as they take place. Getting regular checks ups done and getting diagnosed for the problem when the earliest symptoms begin to show are both crucial for prostate cancer.


Prevention Of Prostate Cancer

At the point when our bodies process the protein we eat, the procedure creates waste products. In the kidneys, millions of tiny blood vessels act as filters since they have even tinier holes in them. As blood flows through these vessels, little molecules such as waste items may press through the gaps. These waste items turn out to be a part of the urine. Helpful substances such as protein and red blood cells are too enormous to go through the gaps in the filter and stay in the blood.

Diabetes and kidneys: Diabetes can harm the kidneys. Abnormal amount of glucose make the kidneys filter a lot of blood. After a couple of years, they begin to spill and helpful protein is thereby lost in urine. Having low protein levels in the urine is called micro albuminuria.

Medication: When kidney disease is analyzed on time, during micro albuminuria, a few medications may keep kidney disease from getting worse. Having elevated levels of protein in the urine is called macro albuminuria. When kidney disease is looked up some other time during macro albuminuria, end-stage renal disease (ESRD) usually follows.

Causes: Strain on the organs may cause the kidneys to lose their filtering capacity. Waste items then begin to develop in the blood. Finally, the kidneys start to fail. This failure, ESRD, is intense. A patient with ESRD needs a kidney transplant or a blood filtration by a machine (dialysis).

Other complications: Individuals with diabetes will probably have other kidney-related issues such as bladder infections and nerve damages in the bladder.

Preventing complications: Not everybody with diabetes goes through a kidney disease. Elements that can impact kidney disease improvement include genetics, blood sugar control and blood pressure. The more a person keeps diabetes and blood pressure under control, the lower the chances of getting a kidney disease.

Keeping your glucose levels high can counteract diabetic kidney problems. Research has demonstrated that blood glucose control diminishes the danger of micro albuminuria by 33%. For individuals who suffer from micro albuminuria have now a reduced danger of advancing to macro albuminuria. Different studies have recommended that blood glucose control can reverse micro albuminuria.

Treatment: Essential treatments for kidney infection include control of blood glucose and blood pressure. Blood pressure dramatically affects the rate at which the condition progresses. Indeed, even a gentle increase in blood pressure can rapidly aggravate a kidney infection. Four approaches to bring down your blood pressure are:

Shedding pounds
Eating less salt
Maintaining a strategic distance from liquor and tobacco
Exercising regularly
A low-protein diet can decrease the amount of lost protein in the urine and increase the protein levels in the blood. Never begin a low-protein diet without talking to your physician.

Diabetes - How It Impacts Your Kidney?

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

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