It is a serious complication of diabetes mellitus, particularly type 1 and type 2 diabetes, affecting a significant number of individuals worldwide. In this blog, you will find a comprehensive explanation.
It is commonly referred to as diabetic nephropathy, a kidney disease that advances due to diabetes mellitus. This condition involves the deterioration of the small blood vessels within the kidneys, resulting in gradual impairment of kidney function.
Risk Factors
Poorly controlled diabetes is the primary risk factor for DKD. Other risk factors include hypertension, genetics, smoking, and prolonged diabetes duration.
Clinical Stages
DKD progresses through several stages:
- Stage 1 (Early DKD): Kidney damage with normal or mildly increased filtration rate.
- Stage 2 (Moderate DKD): Decreased glomerular filtration rate (GFR) and mild to moderate proteinuria (protein in urine).
- Stage 3 (Severe DKD): Significant decrease in GFR and worsening proteinuria.
- Stage 4 (End-stage DKD): Kidney failure requiring dialysis or transplantation.
Symptoms
In the initial stages, DKD might show no symptoms. As the condition advances, signs such as fatigue, swelling (edema), foamy urine (proteinuria), trouble focusing, and reduced appetite may appear.
Diagnostic Tests
- Urine tests for albuminuria (protein in urine) and estimated GFR.
- Blood tests to measure serum creatinine and blood urea nitrogen (BUN) levels.
- Imaging studies (e.g., ultrasound) to assess kidney size and structure.
Management and Treatment
- Control of Blood Glucose: Tight glycaemic control through diet, exercise, and medications
- Control of Blood Pressure: Medications to manage hypertension and reduce proteinuria.
- Lifestyle Modifications: Smoking cessation, weight management, and dietary changes to reduce sodium and protein intake.
- Regular Monitoring: Routine blood and urine tests to assess kidney function.
Complications
- DKD increases the risk of cardiovascular disease, including heart attacks and strokes.
- It can also lead to other complications such as electrolyte imbalances, anaemia, and bone disease.
Prevention
- Early detection and management of diabetes.
- Regular medical check-ups to monitor kidney function.
- Lifestyle modifications to maintain a healthy weight, exercise regularly, and avoid smoking.
Diabetic nephropathy is a chronic kidney disease caused by diabetes mellitus, characterized by damage to the kidneys’ blood vessels. Timely management of diabetes and blood pressure is essential to slow its progression and reduce the risk of kidney failure. Research advancements hold promise for better treatments and outcomes in the future.
