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

Blood in urine, medically known as Hematuria is not usually a cause of concern, but it can translate into an adverse condition if left unevaluated. The kidneys and other structures in the urinary tracts such as urethra (tube connecting the bladder to the outer part of the body); bladder (that stores the urine) and ureters (tube joining the bladder to the kidney) are the sources of blood flow to the urine. Hematuria can be accompanied by symptoms such as discharge of tea-colored, brownish-red or pink colored urine due to the presence of red blood cells, traces of which can only be detected under the microscope.

Underlying causes behind this disorder might be

Urinary tract infections is where the bacteria enter the body through the urethra and begin to proliferate in the bladder.
Kidney infections (pyelonephritis) is when bacteria infiltrate into the kidneys from the bloodstream or travel up from the uterus to the kidneys.
A kidney or a bladder stone is marked by the minerals in the concentrated urine precipitating out and molding into crystals that deposit on the bladder or kidney walls.
Enlarged prostate is a condition in which the prostate gland, that is situated just below the bladder surrounding the upper part of the urethra, starts growing as males head towards their middle age.
Kidney disease such as glomerulonephritis causes swelling of the kidneys, thus disrupting the filtering system.
Bladder, kidney and prostate cancer are also possible causes.
Hereditary disorders such as sickle cell anemia (a hereditary disease of the red blood cells in the hemoglobin) can also pose as a cause behind this disorder.
Kidney injury as a result of heavy blows, accidents or injuries sustained while playing a spot can also contribute to this condition.
Medications such as penicillin or the anti-cancer drug  cyclophosphamide 
Strenuous physical exercises like intense workout or running may also result in Hematuria.
Treatments
There is no fixed cure for Hematuria; instead the doctor would work on treating the repressed conditions behind the symptoms, such as prescribing antibiotics to heal the urinary tract infection or a medicine to shrink and normalize the enlarged prostate or administer a shock wave therapy to destroy the kidney or bladder stones.

Blood in Urine - 10 Causes Behind It

The kidneys make urine, which is a fluid through which wastes from the body including urea are eliminated from the body. There are two kidneys on the right and left side, which make urine, and pass it down to the bladder through tubes known as ureter. The bladder acts as a reservoir of the urine that is formed in the kidneys. It is stored temporarily there before being excreted out of the body through the urethra. The urinary bladder is a highly muscular organ and has a rich connective tissue. 

Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a very common condition, which affects females more than males. While the exact etiology is not known, it could be age-related and also lifestyle related. People who are used to controlling the urge to pass urine are highly likely to develop this condition. The simple logic is that there is additional pressure on the bladder from the urine that is contained for longer period of time. As such, the muscular wall stretches and begins to feel stressed.

When this habit continues over a period of time, the bladder wall may become irritated or inflamed or even scarred in severe cases. There is no role of bacteria in this condition, and antibiotics are of no help in managing this condition (though the name cystitis usually indicates infection).

The following symptoms are seen as a result of this constant irritation and inflammation.

One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
Women may experience pain in the vaginal tract including vulva and behind the vagina.
Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
There is an increased urge to urinate, which may be as much as 9 to 10 times a day. As the condition progresses, there could be more visits, as many as 40 to 50 visits a day.
This tendency and urge to urinate increases during nighttime.
For women, this urge to urinate and other symptoms including pain are worse during menstruation.
There could be pain during intercourse for both men and women.
There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
At a structural level, this constant pressure leads to pinpoint bleeding (glomerulations) and sometimes even ulcers in the bladder wall.
There is no definitive treatment for IC or PBS. However, bladder distention and instillation are proven methods of increasing bladder capacity, which therefore helps in relieving symptoms.

Painful Bladder Syndrome - Know The Signs!

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!

The main task of the kidneys is to balance the electrolytes in the blood and maintain the pH homeostasis. The kidneys also remove waste products from the blood. Infections in the kidney aren t uncommon and affect women (majorly pregnant women) and children below the age of two in most conditions.

Kidney infections are of two types:

Uncomplicated kidney infection: The infections in this condition are minor and can be cured with minimal medication.
Complicated kidney infection: These infections are more complex and serious as compared to the uncomplicated ones.
If not treated on time, kidney infection can prove to become a serious condition and lead to various complications including kidney damage and blood poisoning (sepsis).

The most common causes of kidney infections are:

Weak immune system: If you have a weak immune system, you are prone to getting a bacterial or fungal infection on the surface of your skin which eventually enters the bloodstream. The infection might right reach the kidneys and cause an infection there.
Bacteria entering from the urethra: The pathogen which causes an infection can enter the body through the urethra and multiply in the bladder. The infection spreads to the kidneys and causes renal infection.
Kidney stones: People diagnosed with kidney stones are at a very high risk of developing kidney infections. Kidney stones are caused because of a build-up of dissolved minerals in the inner lining of the kidneys.
Enlarged prostate: Men with an excessively enlarged prostate are prone to developing kidney infections as compared to men with a normal-sized prostate.
Intercourse: Engaging in sexual (anal or vaginal) intercourse with an infected person can be a major reason for kidney infection as the bacteria can enter the body through the anus or the vagina and affect the kidneys.
It is not difficult to detect infection in the kidneys as they have very visible symptoms. A few symptoms of kidney infection are:

Excessive back pain
Sudden chills or fever
Nausea and puking
Blood in the urine
Pain while urinating

Kidney Infections - Factors That Put You At Risk!

The presence of blood in urine is known as Haematuria. It is categorized under 2 types:

    Macroscopic haematuria, which means the patient has seen blood.
    Microscopic dipstick haematuria, which means blood is identified by urine microscopy or by dipstick testing either in association with other urological symptoms (symptomatic microscopic haematuria) or during a routine medical examination. It has been variably defined as 3 or more , 5 or more or 10 or more Red Blood Cells (RBCs) per high - power field.

Urological and other Causes of Hematuria

    Cancer: Bladder, Kidney and Prostate Cancer
    Stones: Kidney, Ureteric
    Bladder Infections: Bacterial tuberculosis, infective urethritis Inflammation
    Interstitial Cystitis Trauma : Kidney, bladder, urethra, pelvic fracture causing urethral rupture
    Renal cystic disease: (e.g. medullary sponge kidney)
    Other urological causes: Benign prostatic hyperplasia, vascular malformations
    Other medical causes of haematuria: anticoagulation therapy (e.g. asprin, anti platelet therapy) Nephrological Causes: more likely in children and young adults, proteinuria; red blood cell casts.
    Urological investigations: Urine culture, urine cytology, cystoscopy, renal ultrasonography and intravenous Urography and CT Urography.

Management of haematuria depends on the cause as determined by the urologist.

Causes and Treatment for Hematuria

Don't wait any longer, manage your Renal Dietician online with a Lybrate doctor today

Consult for Renal Dietician - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES