Diabetes can affect the kidneys in a number of ways but one of the most important complications is diabetic nephropathy. This is a kidney condition that occurs in people with long-standing uncontrolled diabetes mellitus and results in progressive damage to the small filtering units of the kidney (glomeruli).This eventually leads to large amounts of protein in the urine, high blood pressure and declining kidney function.On the occasion of World Diabetes Day, let us explore the occurrence of diabetic nephropathy in case of Indian diabetic population. World Diabetes Day is celebrated each year on November 14, since 1991.Dr S Sundar, Director and Chief Nephrologist, Columbia Asia, highlights “Diabetic nephropathy accounts for half of all the of kidney failure patients needing dialysis or kidney transplant in India. One third of all diabetics will develop kidney failure in the course of 10 to 20 years. Uncontrolled sugars hasten the need for dialysis in such patients. Good control of sugars and healthy lifestyle in diabetics can protect the kidneys. Kidney disease in a diabetic patient exists as a silent process; in other words there may be no specific symptoms until the kidneys fail completely. Also, kidney failure usually occurs only in late stages of the disease, when kidney function has diminished to less than 25 percent of normal capacity. A number of factors appear to increase the risk of kidney disease in a diabetic patient.These include:■ High blood pressure■ High blood glucose levels (particularly in the early stages of diabetes)■ Smoking■ Family history of diabetes and diabetic nephropathy■ Obesity With the use of injectable insulin, people who have had diabetes for some time often suffer from damage to the small blood vessels of the body.This may also affect the delicate blood vessels in the filters of the kidney (the glomeruli).Diabetes is also reported to affect the nerves in many parts of the body leading to Diabetic Neuropathy.When the bladder is affected, it may be difficult to pass urine.If urine builds up in the bladder, the pressure can cause it to flow back into the kidneys and cause scarring to kidney tissue.Also, Urine of diabetic patients has high sugar content. This encourages growth of bacteria and kidney infections may occur. People with diabetes must take special care to ensure any infections are treated immediately.Suggests Dr Sudharshan Ballal, Chairman-Medical Advisory Board and Medical Director, Manipal Hospital, Bangalore, “Certain tests like detection of micro-albuminuria can help to detect kidney damage at an early stage. There are also treatments, which may help to delay kidney failure. It is usually necessary to start these treatments as soon as early signs of diabetic nephropathy are reported. Therefore, it is very important that a diabetic patient should keep a check on their kidney functions.”It is quite often recommended that people with diabetes should be screened regularly for kidney diseases. Hence, taking care of your blood sugar levels well, before reaching the stage of diabetic nephropathy, is surely a good idea.So wake up before its too late.
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