DIABETIC KIDNEY DISEASE

                                     DIABETIC KIDNEY DISEASE

What is Diabetic Kidney Disease??

Diabetic Kidney Disease (diabetic nephropathy) is a complication that occurs in some people with diabetes.In this condition the filters of the kidneys, the glomeruli, become damaged.Because of this the kidney leak abnormal amounts of protein from the blood into the urine.The main protein that leaks out from the damaged kidneys is called albumin.In normal healthy kidneys there are  only a tiny amount of albumin is found in the urine.

A raised level of albumin in the urine is typical first sign that is kidney have become damaged by diabetes.

Diabetic Kidney disease is divided into two main categories,depending on how much albumin is lost through kidneys:

1. Microalbuminuria: In this condition, the amount of albumin that leaks into the urine    is between 30 and 300mg per day.It is sometimes called incipient nephropathy.
2. Proteinuria: In this condition the amount of albumin that leaks into the urine is more than 300 mg per day.It is some time called macroalbuminuria or overt nephropathy.

SYMPTOMS:- The symptoms at first tend to be vague and nonspecific,such as feeling tired,having less energy rather than usual and just not feeling well.More severe kidney disease,symptoms that may develop include:- Albumin or protein in the urine,High Blood Pressure,Ankle and leg swelling,leg cramps,Going to the bathroom more often at night,High level of Blood urea nitrogen (BUN) and serum creatinine,Less need for insulin or antidiabetic medications,Morning sickness,nausea and vomiting are the main symptoms of diabetic nephropathy.

CAUSES:- The cause of diabetic nephropathy is not well understood,but it is thought that high blood sugar advanced glycation end product formation and cytokines may be involved in the development diabetic nephropathy.

Kidney damage is likely if one or more of following is present: Poor control of blood glucose,High blood pressure,Type2 diabetes mellitus(after age 30),History of cigarette smoking ,A family history of Kidney problems.

TREATMENT:- Mees used for initial treatment of diabetic nephropathy are: Angiotensin- converting enzyme (ACE) inhibitors,like-captopril,enalapril,lisinopril and ramipril.ACE inhibitors can lower the amount of protein being lost in the urine.The basis for the prevention of diabetic nephropathy is treatment of its known risk factors ie: hypertension,hyperglycemia,smoking and dyslipidemia.These are also risk factors for cardiovascular disease and should be vigorously treated.