PATHOGENESIS, CLINICAL MANIFESTATIONS, AND NATURAL HISTORY OF DIABETIC KIDNEY DISEASE

WHAT IS DIABETIC KIDNEY DISEASE?

When the kidney functions improperly in some people who have diabetes, that situation is called diabetic kidney disease. It means the kidney has stopped functioning properly to remove waste from the body, which, if they build up, may cause other issues. The main job of the kidney here is to extract excess water and filter wastes out of the blood to make urine.

 

Diabetic Kidney Disease is also popularly known as chronic kidney disease, kidney disease of diabetes, or diabetic nephropathy.

 

HOW DOES DIABETES CAUSE KIDNEY DISEASE?

When you have high sugar in the blood, that causes damage to the blood vessels in the kidney. In such a case the vessels in the kidney stop working. Some people with diabetes also develop high blood pressure, which can damage the kidneys as well. If your blood pressure or blood sugar level is high, there is a very high chance that you will develop kidney disease. 

HOW CAN WE KNOW IF WE HAVE DIABETIC KIDNEY DISEASE?

Most people do not show any symptoms in such a situation. The best way to know is to get a kidney check-up. Blood and urine samples are taken to check for diabetic kidney disease. A test taken every year is beneficial for people who have had type 2  diabetes and type 1 diabetes for more than 5 years.

The best way to slow down or prevent diabetes is to take proper medications and maintain a healthy lifestyle.

 

PATHOLOGY

  • Because of the growing occurrence of diabetes reaching epidemic proportions globally, diabetic nephropathy and associated end-level renal failure will be an unavoidable principal health burden to most families and individuals in advanced and growing countries.
  •  Over the past decade, a huge number of research bodies have centered on diabetic nephropathy ranging from research in molecular signaling, hemodynamic law, and pharmaceutical intervention to clinical results.  
  • It’s far from all likelihood that the pathophysiology of diabetic nephropathy entails a multifactorial interaction among metabolic and hemodynamic factors. 
  • Metabolic elements involve glucose‐based pathways, along with advanced glycation quit‐merchandise and their receptors. 
  • Hemodynamic elements consist of various vasoactive hormones, together with components of the renin-angiotensin device. 
  • It’s far likely that these elements cause pathological damage no longer only to the glomerulus, but additionally to the tubulointerstitium. 
  • Precise inhibitors of the diverse pathways are actually available and these rising pharmaceutical interventions would possibly have capability implications for the prevention and treatment of diabetic nephropathy.

 

NATURAL HISTORY

  • The earliest scientific proof of diabetic nephropathy is microalbuminuria. 
  • Progression from microalbuminuria to overt nephropathy happens in 20–40% within 10 years, with approximately 20% of these patients progressing to end-stage renal ailment. End-degree renal ailment develops in 50% of sufferers with type 1 diabetes with overt nephropathy within 10 years and in extra than 75% within two decades without remedy. 
  • In type 2 diabetes, an extra share of patients has microalbuminuria and overt nephropathy at or quickly after the prognosis of diabetes. 
  • The prevalence of diabetes is increasing internationally, with the next increase in the prevalence of diabetic nephropathy. 
  • Hazard elements for the development of DN from longitudinal and cross-sectional research encompass race, genetic susceptibility, hypertension, hyperglycemia, hyperfiltration, smoking, superior age, male gender, and excessive-protein food regimen. 
  • Treatment interventions for diabetic nephropathy consist of glycemic manipulation, the remedy of hypertension, hyperlipidemia, smoking cessation, protein limit, and renal substitute remedy. A multifactorial method involves mixed therapy targeting hyperglycemia, high blood pressure, microalbuminuria, and dyslipidemia.

 

CLINICAL MANIFESTATIONS

Clinical manifestations or symptoms of diabetic kidney disease are as follows:

  • no blood pressure control
  • Protein in the urine
  • Swelling of feet, ankles, hands, or eyes
  • High urge to urinate
  • Reduced want for insulin or diabetes medicine
  • Difficulty in concentrating
  • Shortening of breath
  • Loss of hunger
  • Nausea and vomiting
  • Continuous itching
  • Fatigue

 

HOW TO MAINTAIN A HEALTHY LIFESTYLE?

 

The steps mentioned below will help you keep your kidney healthy:

  • Stop smoking.
  • Work with a dietitian and create a meal plan.
  • Make physical activities part of your routine.
  • Stay at or get to a healthy weight.
  • Get 7 to 8 hours of sleep each night.

 

The best way to prevent or stop the growth of such a disease is to see a renal doctor and consult advice and treatments from them.

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