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Last Updated: September 09, 2019
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Diabetic Kidney Disease: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Diabetic Kidney Disease or Diabetic Neoropathy is the kidney disease which arises from diabeties. Prolonged kidney disease from diabetes, leads to kidney failure. Almost one third of the population going through diabetes, have shown symptoms of diabetic neuropathy. People with diabetic kidney disease tend to suffer more than those with just kidney disease. The sole reason being, that diabetic people have multiple long-standing medical issues, like high cholesterol, high blood pressure and blood vessel disease (atherosclerosis).

The progression of diabetic neuropathy is absolutely necessary to be controlled by maintaining blood sugar levels and lowering blood pressure. There are certain medicines available to slow down the development of kidney failure. One such medicine is angiotensin converting enzyme (ACE) inhibitors, known to help with that. Although ACE inhibitors like quinapril (Accupril), lisinopril (Prinivil, Zestril) and ramipril (Altace), are usually used for the treatment of high blood pressure, they are used for other medical problems too and are mostly given to diabetic people to prevent or overcome complications, even in case of normal blood pressure. If a person undergoes side effects from the intake of these ACE inhibitors, he is given a different class of drugs known as angiotensin receptor blockers (ARBs).

How is the treatment done?

It is important to keep your blood pressure and blood sugar level under control. This can be done with a proper diet chart avoiding fatty, sweet and high cholesterol food items. You may want to subdue the amount of protein in your diet. Kidney function can be preserved by limiting the amount of protein in your diet, if diabetes has happened to have affected your kidney.

The kidneys will continue to fail and a substantial amount of protein may be detected in the urine if this disease is left untreated. Limiting the salt intake in your diet will help your kidney by preventing the high blood pressure from getting worse. Regular exercise or long walks will prove highly beneficial in maintaining your kidney’s health and keeping diabetes under control. The most serious treatment methods include hospitalization, proper nursing, transplant and dialysis, in case of kidney failure. The normal functioning of the kidney is replaced by dialysis or a kidney transplant. Treatment for dialysis usually takes place in a dialysis unit, with special machines and equipments. Under this method, two needles are inserted into the fistula or the graft. One machine cleans the blood and the other needle allows blood to go back to the patient’s body. Throughout the entire time the person’s blood pressure is measured and the dialysis machine adjusted, to ensure the proper quantity of fluid being removed from the body of the patient. This type of treatment can be advantageous or disadvantageous depending on the person’s medical conditions or support systems.

Who is eligible for the treatment? (When is the treatment done?)

A person with body mass index lower than 40, is eligible to get the treatment like dialysis or a kidney transplant. Inactive or controlled psychological problems make a person eligible. Other eligibility criteria includes, compliance with medications or medical regimens, adequate support system of parents, family, or other people who provide care, absence of any chronic untreated infection, or a clear urinary tract for a proper operation.

Who is not eligible for the treatment?

Under certain conditions, a patient is excluded from getting dialysis or a kidney transplant. These conditions include, active malignancy (cancer), active abuse of alcohol, drugs or other substances, severe pulmonary hypertension that cannot be treated or even controlled, inability to cover the costs related to kidney transplant, or lack of insurance coverage preclude a person from getting the treatment.

Are there any side effects?

During the progression of the kidney diseases, the doctor prescrives activated forms of vitamin D. These drugs often cause hypercalcemia (high calcium levels). This further leads to weariness, loss of appetite, inability to think clearly, vomiting, nausea, weight loss, etc. Vitamin D’s alternatives are phosphate binders which often cause bowel obstruction, fecal impaction and constipation as side effects.

What are the post-treatment guidelines?

Continuous monitoring of glucose level in patients is a must after hemodialysis (HD) treatment. To avoid the dangers of hyper or hypoglycemia, doctors recommend the individualization of insulin regimens. In patients having received peritoneal dialysis (PD) there is a risk of exposure to a large amount of glucose which may eventually lead to uncontrolled hyperglycemia. Patients who are receiving continuous PD are recommended a standard basal insulin regimen. To reduce the progression of diabetic kidney diseases, a multifaceted care program with a multifactoral approach through a nephrologist, diabetes educator or a diabetologist is needed.

How long does it take to recover?

After the kidney transplant surgery or dialysis treatment the patent might be asked to stay for observation in the hospital for two to three days. The patient may not be able to consume solid food so nutrients will be provided intravenously. It is possible for a patient to undergo an infection after recovery. The recovery from the surgery lasts for a week or two. The patient must go for a follow up after surgery and regular checkups accordingly.

What is the price of the treatment in India?

The direct cost of the treating the diabetic kidney diseases may vary, as reported by a few journals. The cost of treatment is determined at two levels. Firstly, the cost of hospitalization and secondly, the overall cost of treatment, which includes consultation, hospitalization, laboratory tests, medication, dialysis treatment, transplantation and transportation surgery. Not much to our surprise, the cost of diabetic kidney disease treatment incurred a very high expenditure. On average Rs. 5,00,000 for a dialysis patient and Rs. 3,50,000 for a transplant patient. For a normal patient, the average cost of treatment is Rs 30,000- Rs. 1,00,000.

Are the results of the treatment permanent?

The results of diabetic kidney disease treatment can never be permanent and there is a possibility that it may get worse over time. However, there is always a solution to any problem. With regular exercise and control on blood sugar levels and blood pressure, one can prevent its relapse or slow down kidney failure. Kidney failure means that your kidney is functioning at only 15% of its total capacity. However, most of the time, people with this disease don’t end up with a damaged kidney with proper care and diet.

What are the alternatives to the treatment?

A natural alternative to diabetic kidney treatment is stem cell therapy. Your bone marrow has stem cells known as ‘’mesenchymal stem cells’’ which act as natural defense agents against kidney failure. These stems cells are known to safeguard your kidney from any kind of disease by accelerating the healing process. With stem cell biotherapy, there has been noticeable growth of the healing rate in patients. In this therapy, patients get extracted stem cells, along with proteins known as ‘’growth factors’’, through an IV.

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