Diabetic nephropathy, also known as diabetic kidney disease, is one of the most serious complications of diabetes. It happens when high blood sugar damages the kidneys’ small blood vessels that filter waste from the blood. These changes occur slowly over a period of time. They are silent until considerable damage has happened. That is why diabetic nephropathy can be so dangerous. At that point, symptoms begin to appear.
Studies suggest that around 20 to 30 percent of patients with diabetes will develop kidney disease. It is particularly alarming in India. A multi-center survey found that chronic kidney disease prevalence among patients with type 2 diabetes is over 40 percent. Diabetic nephropathy has become the leading cause of end-stage kidney disease in North India. Luckily, there are ways to slow the damage to kidneys, even after diagnosis. The following six tips will help you keep your kidneys healthy.
1. Maintain Strict Blood Sugar Control
Elevated blood sugar is the major factor that leads to kidney damage in patients with diabetes. High glucose levels interfere with the functioning of the kidneys and damage the tiny filtering units in the kidneys, leading to loss of proteins in the urine. The kidneys slowly lose their ability to remove wastes from the body.
For people who have diabetes and kidney disease, maintaining HbA1c at 7% or below is the recommended target. This can be achieved by regularly testing blood sugar and taking medication and a balanced diet. Controlling blood sugar levels will reduce the risk of developing microalbuminuria. This is an early sign of kidney disease.
2. Control Your Blood Pressure
High blood pressure both causes and is a consequence of kidney disease. The higher the pressure, the more stress is put on the already damaged filters, which leads to faster decline of kidney function. When it comes to diabetic nephropathy, the target blood pressure should be below 130/80 mmHg.
Such medications as ACE, inhibitors and ARBs are used as the first line treatment, which aim at protecting the kidneys. Apart from decreasing the blood pressure, they reduce protein loss in urine and slow down the progression of nephropathy. The studies prove that they are beneficial for patients with diabetes independently of their blood pressure. The timely introduction of these drugs, even when blood pressure is normal, is recommended when there is a positive albumin test.
3. Get Regular Kidney Function Tests
Since the onset of diabetic nephropathy is asymptomatic, testing is usually recommended to routinely screen the kidney function in order to detect the disease in its earliest stages. All patients with type 2 diabetes need to have a kidney function test at the time of diagnosis and at least once a year after that. Meanwhile, people with type 1 diabetes should start the screening process five years after diagnosis.
There are two tests that can determine how well the kidneys function. One is a simple urine test that detects the presence of albumin. Albumin is a type of protein that should not be present ideally in urine in abundance. Another test is a blood test that measures the estimated glomerular filtration rate (eGFR). A timely diagnosis allows treating the disorder before it could causes any severe and permanent damage.
4. Adopt Kidney-Friendly Eating Habits
The kidney function is primarily determined by the kind of food that people consume. In particular, the Mediterranean-like dietary model proved to be highly efficient in diabetic nephropathy patients due to its focus on whole food, plant-based, and fish-rich nutrition, alongside healthy fats and a reduced amount of processed foods.
The salt intake needs to be carefully controlled since it can increase blood pressure levels and cause fluid retention. The recommended amount of sodium should not be more than 2,300 mg per day. The protein consumption should not exceed 0.8 to 1.2 grams per 1 kilogram of body weight. Ideally speaking animal protein, dairy and meat products with low fat content are better and this can reduce the load on kidneys.
5. Stay Physically Active
Engaging in physical activity helps to reduce blood sugar and blood pressure levels. Both these indicators are needed for proper functioning of the kidneys. Studies have found that a supervised exercise program along with physical activity with dietary changes can help reduce inflammation and oxidative stress in people with diabetic nephropathy.
It is recommended that people engage in at least 30 minutes of moderate-intensity physical activity most days of the week. A good way to start is to go for walks as this type of activity is easy on the joints. It is best to consult with a healthcare professional before starting an exercise program, especially for people whose kidney disease has progressed to the end stage. Testing blood sugar levels before and after physical activity is important to avoid low blood sugar. It is recommended to carry glucose tablets during physical activity.
6. Avoid Nephrotoxins and Manage Other Risk Factors
There are certain things that can harm the kidneys directly, so it is important to avoid them. For instance, NSAIDs, such as ibuprofen and naproxen, may reduce kidney blood flow and should be taken sparingly. Another thing that increases the risks of kidney damage is smoking, which damages blood vessels all over the body, including those in the kidneys, and accelerates the development of the disease.
- Make sure to inform your diabetic doctor about all the medications and supplements you take.
- Get vaccinated against the flu and other diseases.
- Maintain a healthy weight.
- Manage the cholesterol levels in the blood with statins.
Diabetic nephropathy is a severe but preventable and controllable complication of diabetes. Tight glycemic control, regulation of blood pressure, prescribed medical tests, a healthy diet, regular exercising, and no harmful habits are the ways of preventing and treating chronic kidney disease successfully. The key to avoiding health issues is to take care of the body, monitor the condition of kidneys, and maintain a high level of health. The kidneys perform an immense quantity of work per day. Therefore, it is important to help them by maintaining a healthy lifestyle.
