Kidney disease in people with diabetes
Dr Adrian Brown, Senior Research Fellow and Specialist Dietitian, University College, London
People with diabetes are at risk of developing kidney disease because diabetes causes several changes in the structure and function of the kidney that over several years can lead to reduced function and progression towards kidney failure. Consequently, it is important to be aware of this risk and where possible try to reduce it.
In this episode Dr Adrian Brown discusses the nature of the condition, how to be aware that there is a problem and what can be done in the light of present knowledge to reduce the risks of developing kidney disease. Early detection is key.
Early signs and symptoms include:
- Fatigue
- Nocturia (getting up at night to pass urine)
- Swelling of ankles, feet, legs and hands (due to fluid accumulation)
- Excess protein in urine – seen as foam on urine
- High blood pressure.
Where blood and urine tests are available these should be checked at appropriate intervals to help monitor progression.
Good control of blood sugar (glucose) and effective treatment of high blood pressure are important. So too is reducing a high body weight, bearing in mind that in the people of South Asia body weight-related risks may be present at lower weights than in Europeans. Dr Brown noted that reducing weight may be more important than previously realized. Overweight and obesity are independent risk factors for chronic kidney disease and, in diabetes are known to accelerate progression of the condition. Losing sufficient weight has been shown to improve control of blood glucose and improve insulin resistance, as well as reducing blood pressure. As was discussed by Prof Mike Lean in episode three ( Click here ) weight loss can also put recently diagnosed diabetes into remission. Long term weight loss has been shown in people in Sweden who had surgery for obesity around 18 years ago and this significantly reduces the risk of kidney disease. It is important to stop smoking, attend regular medical checks, where this is possible, and use medications as prescribed. As the condition progresses some specific changes to diet may well be beneficial.
For those who believe that they may be at risk of developing diabetes, on-line diabetes risk calculators are given in the links below. Links to potentially useful sites giving more information about kidney function in diabetes are also given.
Kidney disease in people with diabetes:
US:
US: National Kidney Foundation:
Canada:
and
Pakistan: Epidemiology and demography of Chronic Kidney Disease:
Malaysia: National Kidney Foundation patient leaflet:
Continued page 2
Diabetes prevention:
International Diabetes Federation:
South Asia:
The Indian Diabetes risk score:
East Asia:
Diabetes Hong Kong – Are you at high risk of diabetes?
Chinese language online risk calculator: Go to:
Sunway Medical – Malaysia – Know your risk – and choose Chinese language
South-East Asia:
Europe/Middle East and North America:
The Canadian Diabetes Risk calculator:
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