Kidney failure is a very common complication caused by diabetes. More dangerous, the symptoms of kidney disease progress silently, often detected only when end stage renal failure, causing patients to periodically dialysis, kidney transplant …This complication can occur at the time of diagnosis of type 2 diabetes or 10 years after the illness is acquired. Without proper and timely treatment, it can lead to kidney failure, kidney fibrosis, life-threatening at any time.
The incidence and severity of kidney complications are related to duration of illness and degree of glycemic control. According to statistics, about 20-40% of diabetic patients will have kidney complications, in which many patients with type 2 diabetes have proteinuria as soon as their diabetes is detected, and for type 1 diabetics, then 10 years of illness, about 50% of patients have had end stage renal failure and after 20 years this number has reached 75%. In the kidney departments, about 40% of patients are undergoing hemodialysis due to kidney complications of diabetes.
Diabetes causes many dangerous complications, in which about 20-40% of diabetic patients lead to kidney failure. So why does diabetes lead to kidney failure, how is it manifest, how to treat and prevent it?.
1. Why diabetes leads to kidney failure?
Why does diabetes lead to kidney failure? ” is the question of many patients with diabetes. Diabetic renal failure, also known as Kimmelstiel Wilson syndrome, is a condition in which the kidney function is significantly impaired, which is caused by diabetes.
The pathogenesis of this diabetic renal failure complication is complex. Normally, blood will flow into the kidneys through the kidney arteries with countless tiny blood vessels and concentrated in small tufts called glomeruli. However, in diabetic patients, prolonged high blood sugar will produce more oxidants that damage the glomerular capillaries.
When the blood sugar level is too high, exceeding the sugar level of the kidneys cause this organ to be overactive, after a long time it will make the holes bigger, causing protein to leak out, affecting renal function. This condition, due to the lack of timely treatment, causes the kidneys to gradually become fibrosis and completely lose its function, and the patient is now forced to use dialysis or a kidney transplant to treat and prolong life.
For diabetics, the transmission of nerve signals from the brain to the organs is malfunctioning, the bladder is less stimulated, there is no feeling when the bladder is full of urine, long stagnation causes urinary tract infections. The bacteria go back up to the kidneys, damaging the kidneys and leading to kidney failure.
2. Signs of kidney failure complications
In the early stages, the kidneys still have the ability to increase activity to compensate for the damaged capillaries. Therefore, kidney function is still normal, the patient has no abnormal symptoms. However, as the number of damaged capillaries increases, the kidneys, although more active, can not respond and symptoms of kidney failure appear.
Symptoms of early-stage renal failure are often not so obvious, forexample: edema, insomnia, headache, loss of appetite, fatigue and memory loss, increased blood pressure.
Hypertension can be a symptom of kidney failure, but it may also be a pre-existing increase in blood pressure (usually in type 2 diabetics) and it promotes kidney complications from diabetes worsening.
When a patient has severe kidney structural damage that causes too much protein to be lost in the urine, the amount of protein in the blood is too low to keep fluid in the blood vessels,
leading to the drainage of fluid, causing the patient to have very large swelling of the whole body, with ascites and possibly pleural effusion, pericardial effusion … called nephrotic syndrome. Patients with this nephrotic syndrome are also more likely to progress to severe kidney failure.
Early detection of kidney failure complications in diabetics is extremely important, helping to prevent the serious problems it causes to the patient’s health.
3. How is diabetic kidney disease diagnosed?
The doctor mainly performs annual blood and urine tests to check for early signs of kidney damage. Common tests include:
Check albumin in urine
This test helps to check for the presence of albumin in the urine. Normally, urine does not contain albumin, so the presence of this protein in the urine is an indication of kidney damage. Blood urea test
Blood urea test helps check for the presence of urea nitrogen in the blood. Nitrogen urea forms when proteins are broken down. Blood urea nitrogen levels higher than normal may be a sign of kidney failure.
Test for creatinine in the blood
This test measures the concentration of creatinine in the blood. The kidneys remove creatinine from the body by sending creatinine to the bladder, which is then excreted with urine. If the kidney is damaged, it cannot remove creatinine from the bloodstream as usual. High levels of creatinine in the blood mean the kidneys are not working properly.
If your doctor suspects you have diabetic kidney disease but is unsure, your doctor may perform a kidney biopsy. This is a surgical procedure in which a small sample of one or both kidneys is removed so that they can be viewed under a microscope.
3. Prevention and treatment of Kidney failure from diabetes
There is no cure for diabetic kidney disease, but treatments can delay or stop the disease’s progression. Treatments include controlling blood sugar, lowering blood pressure through medications (when needed), and making lifestyle changes. Your doctor will also recommend a special diet.
If your kidney disease progresses to an advanced stage, you will need to go on to more invasive treatments.
Regularly monitor blood sugar, use the appropriate dose of insulin. You need to take medication as directed by your doctor to keep your blood sugar under control. Your doctor may prescribe an ACE inhibitor (ACE), an angiotensin II receptor blocker (ARB), or other antihypertensive drug to keep your blood pressure stable.
When kidney function is impaired, the kidneys are unable to remove all the waste products from protein, such as urea. Urea accumulates in the body, making you tired, loss of appetite, memory loss, and even coma. Therefore, people with diabetes with kidney disease should limit the amount of protein in their meals.
You need to build a good kidney diet. This diet is usually low in fat, sodium, potassium, phosphorus and fluids. Foods rich in protein should be eaten limited, including cheese, beans, red meat (beef, lamb, pork), eggs, animal viscera, sausages … You should eat foods with low protein such as fish, soybeans, chicken …
Sodium (salt) restriction:
Patients with kidney failure stage 1 to 3 are recommended to use about 2000-3000 mg of salt / day. People with stage 4 kidney failure, sodium levels should only be from 1000 to 1500 mg / day. In case of hypertension, severe edema should eat completely.
Don’t eat more foods containing phosphorus and potassium:
When kidney function is still good, through the kidney dialysis process helps to balance phosphorus levels. Conversely, when the kidneys are not working properly, phosphorus is accumulated in the blood causing osteoporosis. Eat foods high in phosphorus such as whole grain breads, whole grains, oatmeal, sunflower seeds, etc. Instead, eat foods with a low phosphorus content such as white bread, rice, …
When the kidneys are not working well, the amount of potassium in the body is unstable, too high or too low, disturbs in heart function and muscle movement. You should eat foods high in low potassium including: Apples, blueberries, grapes, pineapple, strawberries, cauliflower, onions, peppers, radishes, summer lettuce, lettuce, white bread, chicken, … Limit foods rich in potassium in: cow’s milk, avocado, bananas, melons, oranges, plums, raisins, artichokes, spinach, potatoes, sweet potatoes, tomatoes, black beans and brown rice.
Do not drink a lot of water when kidney function is impaired:
Humans need water to stay alive, but when suffering from kidney disease, drinking plenty of water increases the burden on the kidneys. Depending on the stage of your kidney disease and your physical condition, your doctor may tell you how much fluids you should drink.
You plan exercises to help keep your blood pressure stable and kidneys healthy. Gentle exercise like walking, yoga or tai chi for about 30 minutes a day to stabilize blood sugar.
Treatment of kidney disease caused by end-stage diabetes complications
If your kidney disease progresses to an end stage, you will need dialysis or a kidney transplant beside basic treatment. Dialysis is a method of using a special, specialized machine to filter waste products out of the blood instead of the kidneys. Many patients are prescribed dialysis 3 times / week for four hours a day. You may need less or more treatment, depending on the severity of the illness.
Another option for people with end-stage kidney disease is a kidney transplant. For a kidney transplant, a kidney from a donor is transplanted into your body. The successful rate of dialysis and kidney transplantation depending on each person.
Diabetes leading to kidney failure is a dangerous complication, but it is possible to control and prevent it from getting worse by detecting early and controlling your blood sugar within the permitted range. a healthy routine that protects healthy kidney function.