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Diabetic Nephropathy and Kidney Disease

Diabetic nephropathy, some people also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis (nephropatia diabetica) is a progressive disease of the kidneys as a result of a long, not optimally controlled diabetes mellitus – in which poorly treated – the kidney function is more limiting up to dialysis, kidney failure. Around 30% of people with diabetes type 1 and diabetes type 2 occurs approximately 10 years after onset of diabetic nephropathy (nephropathy diabetes), and men are statistically more frequently affected than women, including low birth weight acts as a favorable factor.

The relevant factors in addition to a hereditary predisposition and the long-term quality of glycemic control. Due to the long-standing elevated blood sugar deposits from changes in the renal corpuscles and scarring caused by the natural filtering function of the kidneys fail gradually. The arteries of the renal vessels calcify increasingly, there is an increase in pressure within the renal corpuscle and a general rise in blood pressure.

The onset of the illness passes unnoticed by the patient, when the nephropathy is broken and is not treated, but it usually leads within 2.5 years for chronic renal failure. Only the symptoms of advanced renal injury in the form of foamy urine (due to the increased protein secretion), edema and weight gain or incipient renal failure with itching, exhaustion, headache, anemia, nausea and vomiting are more noticeable. In the laboratory, the excretion of albumin is increased.

The simultaneous determination of albumin and creatinine in urine is the albumin-creatinine ratio a clear indication of diabetic nephropathy :

The value of 30-300 mg / g is known as microalbuminuria (likelihood of nephropathy after 10 years, diabetes mellitus type 1) very high; more than 300 mg / g is called macroalbuminuria (very high probability) even after a shorter diabetes.

If 2 of 3 samples reach these values, it must be of the diabetic nephropathy. At the risk of renal failure is due to the burden of blood vessels in hypertension, the risk of cardiovascular complications increases significantly. Smoking, higher amounts of protein from the diet, elevated blood lipids and obesity potentiate the risk of a heart attack, stroke, thrombosis, or diabetic complications.

Blood sugar must be terminated permanently optimal, lowered blood pressure and so must be the blood fat levels reduced to well below 100. The goal is to reduce protein excretion to less than 0.5 – 1 g per day.

Regular blood and urine tests to the corresponding values of renal function are mandatory. As standard medications are ACE inhibitors or AT1 antagonists, antihypertensive drugs can stop the disease prophylactically.

A well adjusted blood sugar levels, consistent weight control, regular medical checkups and a generally healthy lifestyle (exercise, protein and fats in moderation, do not smoke) to help reduce the risk of diabetic nephropathy, and significantly delay the progression of existing disease.

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