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Diabetic Nephropathy

Diabetic Nephropathy is a diabetic disease of the kidneys. The main cause is high blood sugar levels and is also helped along by high cholesterol. This disease is the main cause of kidney failure in the United States.

The disease is seen in patients who have had diabetes for 15 years or longer. This is progressive and can cause death within three years. Both type 1 and type 2 diabetics are at risk for this disease.

There are no early symptoms of this. The earliest change that can be detected is a thickening in the glomerulus (this is the main filtering unit of the kidney).

When this happens the kidney may allow more Serum albumin (plasma protein), often referred to simply as albumin in your urine. Albumin is the most abundant plasma protein in humans.

Your doctor can run some sensitive tests to check for increased albumin. As nephropathy progresses more and more of the glomeruli (part of the glomerulus) are destroyed (called glomerulosclerosis) and more albumin is in the urine (proteinuria). When this happens there is also usually an increase in blood pressure (hypertension) and increased levels of fluid retention in your body. Some things that may happen as nephropathy progresses are;

anorexia (poor appetite)

fatigue

swelling, usually around the eyes in the mornings; later, general body swelling may result

frequent hiccups, foamy appearance or excessive frothing of the urine

unintentional weight gain (from fluid accumulation)

nausea and vomiting

malaise (general ill feeling)

headache

generalized itching

Albumin is essential for maintaining the osmotic pressure needed for proper distribution of body fluids between intravascular compartments and body tissues. It also acts as a plasma carrier by non-specifically binding several hydrophobic steroid hormones and as a transport protein for hemin and fatty acids.

Treatment for diabetic nephropathy is usually ACE inhibitors which will decrease the levels of proteinuria. This are the drugs used for hypertension. This disorder can not be stopped, only slowed in its progression. It eventually ends with kidney failure and the need for dialysis and a transplant.

You can slow progression by tight control of blood glucose levels and good control of blood lipids (blood fats).

If you have diabetic nephropathy you should avoid anything containing iodine, nsaids (ibuprofen, naproxen) and COX-2 inhibitors like Celebrex. These tend to damage the kidney.

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