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The prevalence of diabetes is increasing in almost every part of the world.1 It is a long-lasting condition that affects the heart, eyes, nerves and the kidneys, further leading to life-threatening complications with time.(2)

Chronic kidney disease (CKD), caused by kidney damage due to diabetes, is a chronic complication of diabetes that increases the risk of mortality.(3) In this article, we will discuss how diabetes may lead to CKD and its timely management.

What is the association between diabetes and CKD?

CKD is a complication of diabetes in which the kidneys are unable to perform their normal functions such as the filtration of blood and the formation of urine.(1-3) The development of CKD in people with diabetes is a gradual process.(1,3) The damage to the kidneys can also cause many other health complications.(2) You may be able to prevent or delay the process of kidney damage and protect your kidneys by some timely measures.(4)

Are there any symptoms of CKD?

In people with diabetes, there are no visible signs and symptoms until kidney damage occurs.3 After that, the individual shows symptoms of kidney failure caused by the accumulation of waste in the body, such as swelling on the ankles, feet, face, vomiting, loss of appetite, confusion, weakness and headache.(3,4) Regular blood and urine check-up can help in early detection of the condition. If the condition remains undiagnosed or untreated, CKD may lead to end-stage kidney disease that needs dialysis or a kidney transplant.(3) CKD can be diagnosed by the presence of albumin in urine and a high albumin-to-creatinine ratio.(5) People who have had diabetes for more than five years should regularly undergo these tests once every year.(6)

How does diabetes lead to CKD?

High levels of blood glucose in people with diabetes require the kidneys to work harder, which may eventually damage them. As a result, the filtration process by the kidneys gets affected, and proteins, such as albumin, leak into urine. High blood glucose levels also affect the blood vessels in people with diabetes, leading to high blood pressure that may cause further damage to the kidneys.(3)

Are there any preventive measures for CKD?

The following preventive measures can help you to delay or prevent CKD if you have diabetes:(2,4)

    • Keep your blood glucose levels in control.
    • Maintain your blood pressure within the normal range.
    • Keep a watch on the amount of protein intake through diet. Talk to your diabetologist regarding your diet.
    • Live a healthy lifestyle and exercise regularly, quit smoking and maintain healthy weight.

How is CKD managed in people with diabetes?

The vital challenge for people who develop CKD as a complication in diabetes is the management of blood glucose levels and blood pressure. CKD can be managed in the following ways:(1,2)

  • Dialysis: Doctors recommend regular dialysis or, sometimes, kidney transplant In people with end-stage kidney disease.(2,5-7)
  • Lifestyle changes such as regular exercise and a diet with restrictions on protein, sugar and sodium intake.(2-4)
  • Controlling high blood glucose with medications.(2)
  • The appropriate management of hypoglycaemia in patients with CKD who have diabetes as they may experience lowering of glucose levels in the blood.(5)
  • Management of cardiovascular complications due to diabetes and CKD and controlling high blood pressure with regular medications.(2,3)
  • Management of high cholesterol levels in patients with CKD.(2)

Diabetes is associated with serious acute and chronic complications.(2) CKD is one such serious complication that affects many people with diabetes. The best approach towards the prevention of CKD in diabetes is controlling your blood glucose levels and blood pressure.(4) A healthy lifestyle and regular medications and follow-ups can help in delaying kidney issues.(4)

Your health is in your hands. If you have diabetes, you can delay the onset or prevent the occurrence of CKD by following the measures discussed in this article.

Have a healthy lifestyle and stay away from kidney problems arising from diabetes!

References:

  1. Perkovic V, Agarwal R, Fioretto P, Hemmelgarn BR, Levin A, Thomas MC, et al. Management of patients with diabetes and CKD: conclusions from a “Kidney Disease: Improving Global Outcomes” (KDIGO) Controversies Conference. Kidney Int. 2016 Dec;90:1175-1183.
  2. Cleveland Clinic. Diabetes: Preventing complications [Internet]. [updated 2017 Mar 29; cited 2019 Dec 4]. Available from: https://my.clevelandclinic.org/health/articles/10675-diabetes-preventing-complications.
  3. American Heart Association. Kidney disease and diabetes [Internet]. [updated 2016 Jan 31; cited 2019 Dec 4]. Available from: https://www.heart.org/en/health-topics/diabetes/why-diabetes-matters/kidney-disease–diabetes.
  4. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic kidney disease [Internet]. [updated 2017 Feb; cited 2019 Dec 4]. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease.
  5. Cavanaugh, KL. Diabetes management issues for patients with chronic kidney disease. Clin Diab. 2007;25(3):90-97.
  6. Alicic RZ, Rooney MT, Tuttle KR. Diabetic kidney disease: challenges, progress, and possibilities. Clin J Am Soc Nephrol. 2017 Dec 7;12(12):2032-2045.
  7. National Kidney Foundation. Dialysis [Internet]. [cited 2019 Dec 5]. Available from: https://www.kidney.org/atoz/content/dialysisinfo.

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