Diabetes And Kidney Disease
“Nearly 25 million Indians have diabetic kidney disease”
Nearly one-third or 30 per cent of patients world-wide suffer from diabetic kidney disease. The diabetic population of the world numbers 382 million with India being the ‘Diabetic Capital’ of the world with a 65.1 million diabetic population of which nearly 25 million have diabetic kidney disease.
Predisposing factors to diabetic kidney disease include:
- High calorie intake
- Fast food consumption
- High salt intake
- Stressful lifestyle
- Low physical activity
These triggers superimposed on a genetic tendency cause diabetic kidney disease. Indians are particularly predisposed to diabetes due to genetically high levels of insulin resistance. Get a screening test done at Apollo Sugar to rule out the danger of getting kidney disease.
Stages Of Diabetic Kidney Disease
Diabetic kidney disease has five main stages:
Stage 1 is the stage of ‘hyperfiltration’ where the kidneys are working overtime and this is one of the reasons for diabetics urinating frequently.
Stage 2 is the stage of ‘clinical latency’ where there are no symptoms or signs.
Stage 3 is the stage of ‘microalbuminuria’, where microscopic amounts of protein appear in the urine. This is not detected on routine urine examination and needs special methods to identify it. It is the earliest stage at which one can identify diabetic kidney disease by standard laboratory equipment and this is the only stage at which diabetic kidney disease can be reversed. Once it reaches the next stage, there is no chance of recovery or reversal.
Stage 4 is the stage of ‘overt proteinuria’, where there is a large quantity of protein leak in the urine. This is easily detected on routine urine examination.
Stage 5 is the stage of ‘chronic renal insufficiency’, where kidney malfunction starts.
Prevention: Preventive measures in diabetic nephropathy are lifestyle modifications and medications.
Diet – Recommended diet is a restricted carbohydrate, low salt, normal calcium and potassium diet. Aerated drinks, fruit juices and coconut water should be avoided.
Exercise – One hour of moderate exercise daily is mandatory. Anyone who has ever exercised in his/her life would know that a complete exercise schedule takes at least one hour, beginning with warm-ups and stretches and moving on to cardio followed by toning and limb strengthening and ending up with cooling down.
Avoidance of substance abuse – Smoking, along with its other evils, initiates diabetic kidney disease. It also causes kidney damage in non-diabetics. Alcohol consumption should be limited to one beer a week or a couple of pegs of whisky per week. Recreational drugs like cannabis, cocaine, heroin etc should be totally avoided.
Medications to prevent diabetic nephropathy are focussed on blood sugar, blood pressure and lipid control. Once diabetic kidney disease has set in, reversal is possible till stage 3. Once stage 4 has been reached, the treatment is directed at damage limitation and slowing down the progression.
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