Preventing Diabetic Kidney Disease

Disclaimer: This following information is not provided to you by a medical profession but by a non-medical third party and does not in any well replace any advice given to you by such professionals.

In October 2010, I attended a presentation given by Dr. Ray O’Connor on Diabetic Kidney Disease. I’m getting to the stage in my life where I don’t want to rely on luck alone to stave off the complications of diabetes and even though I trust my endo; I want to know more about the medical side of things myself. I am passing along the information that he provided.

Dr. O’Connor is a full time general practitioner (GP) who has a special interest in diabetes and he is also, among other things, the chairperson of a task force in the mid-west of Ireland to co-ordinate diabetes care in the region.

He introduced his topic by stating that most people who have kidney disease do not have any symptoms and feel well. In the image to the right, the part of the iceberg we see above water represents the number of people who know they have kidney disease and the part of the iceberg represents the people who do not know they have kidney disease.

What is Diabetic Kidney Disease?

Diabetic kidney disease affects 20-30% of people with diabetes (Type 1 & Type 2).

When the kidneys are working well, tiny filters in your kidneys, the glomeruli, keep blood proteins inside your body. You need these proteins to stay healthy. High blood glucose and high blood pressure damage the kidneys' filters. When the kidneys are damaged, proteins leak out of the kidneys into the urine. Damaged kidneys do not do a good job of filtering out wastes and extra fluid. Waste and fluid build-up in your blood instead of leaving the body in urine. With more damage, the kidneys leak more and more protein. More and more wastes build up in the blood. This damage gets worse until the kidneys fail.

What’s that Microalbuminuria all about?

The first sign of Kidney disease will appear when the blood vessels start to leak Microalbuminuria (little bits of protein) in the urine. A normal level of Microalbuminuria is less than 2.5. The test to detect if any microalbuminuria is present is called a Albumin:Creatinine Ratio (ACR) and is done through a urine sample and should be done once a year in all people who have diabetes.

How does your doctor screen for Diabetic Kidney Disease?

Your doctor should take a urine sample once a year to have it tested for the Albumin:Creatinine Ratio. A result of less than 2.5 is normal. A result of between 2.5 and 25 is stage 1 kidney disease and a result greater than 25 is stage 2.

How should we prevention Kidney Disease?

Keeping our blood vessels healthy will help keep your kidneys healthy. We do this by;

• Keeping our Blood Pressure under control, using ACE (angiotensin converting enzyme) inhibitors or ARBs (angiotensin receptor blocker), if necessary. Simply reducing our Blood Pressure with other medicines is effective also,

·         Good glucose control,

·         Restriction of dietary protein may be helpful,

·         Stop smoking will relieve the pressure on our blood vessels,

·         Cholesterol control,

·         Lifestyle modifications are helpful too. 

¾     Weight loss

¾     Exercise

¾     Reduction of protein

¾     Reduction of salt

¾     Reduction of alcohol

Conclusion

Dr. O’Connor summed up his presentation with these few points below that were easy to remember.

·         Get your urine tested for the Albumin : Creatinine Ratio (A:C Ration) at least once a year and Blood Pressure checked regularly

·         Keep your sugars controlled

·         Take your medication

·         Don’t smoke

·         Work on your lifestyle

I think it's safe to say that I have not done his presentation justice; you kinda had to be there to absorb the full impact and everyone who did attend walked out with more knowledge and more motivation to take control of their diabetes.