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Diabetic Nephropathy
BY JAMES BROOMFIELD
Diabetic
nephropathy is a description of the damage to a person's kidneys that can occur
due to diabetes mellitus, more commonly called diabetes.
The
damage to the kidneys interferes with normal kidney function.
What is going on in the body?
The
kidney is made up of several million filtering units.
Each
filtering unit contains a membrane to filter the blood, which is how urine is
made.
Diabetes,
a condition that causes high blood sugar levels, can slowly damage these
filtering membranes through a mechanism that is not well understood.
As
this condition gets worse over time, kidney failure may occur.
What are the signs and symptoms
of the condition?
If people with diabetes are not
screened for diabetic nephropathy, many years may pass before symptoms develop.
The
earliest sign of this condition is usually an abnormally high level of protein
in the urine that occurs without symptoms.
Symptoms
of diabetic nephropathy start only after severe kidney damage has occurred and
may include:
· swelling
in the legs
· nausea
and vomiting
· malaise,
a vague feeling of illness
· fatigue
· headache
· itching
· frequent hiccups
· unintended weight
loss
· swelling
of the face
· unintended
weight gain due to fluid buildup
What are the causes and risks of
the condition?
Diabetes mellitus,most often type
1 diabetes, causes this condition.
It
can occur in people whether or not they take insulin for their diabetes.
However, tight control of the blood sugar can help people delay or avoid the
onset of kidney damage and slow its progression. The more out of control the
blood sugar is over time, the more likely kidney damage is to occur.
What can be done to prevent the
condition?
Three primary methods are
recommended to prevent or at least delay the onset of diabetic nephropathy:
close or tight control of blood sugar levelscontrol of blood pressure.
People
with diabetes may even benefit from having blood pressure that is lower than
normal.the use of medications known as angiotensin-converting enzyme (ACE)
inhibitors, such as captopril (i.e., Capoten) or lisinopril (i.e., Prinivil,
Zestril), or ARB-medications, such as losartan (i.e., Cozaar).
How is the condition diagnosed?
Urine testing is done in healthy
people with diabetes to screen for diabetic nephropathy.
These
tests generally show increased amounts of protein in the urine if diabetes has
damaged the kidneys.
Sometimes,
the urine is collected over a 24-hour period to get a more exact measurement of
the amount of kidney damage.
If
kidney damage is severe, blood tests will show decreased kidney function.
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