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Last Updated: Jan 10, 2023
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Diabetic Nephropathy - Tips To Help You Manage It!

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Dr. Sunita SayammagaruEndocrinologist • 21 Years Exp.MBBS, MRCGP ( UK), Diploma in Diabetes (UK), DFSRH (UK), DRCOG (UK), CCT (UK)
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Diabetes is not an isolated disease but a syndrome. It brings with it a host of issues, affecting almost all organs, and that is the reason it is a dreaded issue. Diabetes is the result of chronic inflammation and this inflammation gradually spreads to all other organs. One of the main organs adversely affected is the kidneys. The kidneys are essential filtration agents, and impaired kidney function can have a series of bad effects on the body.

The good news is that not everybody with diabetes will have diabetic nephropathy. However, risk factors for developing diabetic nephropathy are:

  1. Severe, uncontrolled diabetes
  2. Family history
  3. Prior kidney disease, even chronic infection
  4. Race or ethnicity (native Americans, African Americans, etc.)
  5. Preexisting hypertension or high cholesterol levels
  6. Obesity

If you have these risk factors, then all efforts should be aimed at keeping blood sugar at highly optimal level. Once it reaches beyond a certain level, it is very difficult to get it under control.

Symptoms

There would be no symptoms in the initial stages

  1. If you suspect that increased sugar levels could be damaging the kidneys, it is imperative to do renal functions annually to test for onset of kidney malfunction
  2. There could be swelling of the feet and ankles
  3. Urine tests may indicate increased levels of protein in the body (serum albumin in particular)

Management

The idea is to arrest or stop damage to the kidneys.

  1. Reduce and maintain blood pressure within the recommended levels. This will depend on the age and overall health status. Using angiotensin converting enzymes or angiotensin receptor blockers is the most effective way to control hypertension and related kidney damage
  2. Keeping blood sugar within the recommended levels helps reduce or stop damage to the blood vessels in the kidneys and thereby, prevent progression
  3. Maintain optimal levels of cholesterol, as this only adds to hypertension, which further worsens kidney function.
  4. Eat a heart-healthy diet and exercise regularly. It is a vicious cycle with components including hypertension, high sugar levels, increased heart disease, which all only continues in a circle nonstop. Breaking this cyclical trend is very important.
  5. Diet should not be too rich in protein, as the kidney function is impaired and may not be able to handle too much protein. Talk to a nutritionist as to how much protein is required and follow it strictly.
  6. Reduce salt levels in the diet, and strictly do not add extra salt onto your plate
  7. If you are a smoker, this is a great reason to quit, as it affects all the above conditions.
  8. Maintain weight under optimal levels. 

    If you wish to discuss about any specific problem, you can consult an endocrinologist..

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