Healthy Lifestyle Radio Storytime

DEFINITION
Diabetic nephropathy (kidney disease caused by diabetes) has been defined on clinical grounds as persistent proteinuria (protein excretion in the urine entire 500 milligrams a day, or excretion of albumin in the urine of 300 milligrams in a day) in the urine of patients with diabetes who also have diabetic retinopathy (eye disease in patients with diabetes) but have no other kidney.

BACKGROUND

Diabetes mellitus type 1 and type 2 national and global level has become the leading cause of end stage renal disease, that is due to:

1. The increase in the prevalence (number of patients) in type 2 diabetes especially.
2. Patients with diabetes are living longer.
3. Patients with chronic renal failure due to diabetes mellitus are being accepted into dialysis programs / hemodialysis and kidney transplantation of which were previously excluded.

In patients with diabetes mellitus type 1 with 20 years of evolution, 50% of them develop diabetic nephropathy, and patients with type 2 diabetes mellitus only 10 to 20%. However, the great difference in prevalence (most common type 2) causes the majority of patients with diabetic nephropathy is secondary to type 2 diabetes mellitus.

NATURAL HISTORY

The earliest clinical sign of diabetic nephropathy is the appearance of low but abnormal albumin in the urine (more than 30 milligrams a day), which is called microalbuminuria, and microalbuminuria in patients with incipient nephropathy have, simultaneously with these patients develop hypertension (increased pressure in the blood). Without specific treatment of patients with incipient diabetic nephropathy reach the state of overt diabetic nephropathy, and once you get to frank diabetic nephropathy and there is no specific treatment renal function and decreases gradually over several years developing the ESRD.

Diagnosis

It must perform a screening test for microalbuminuria at the time of diagnosis of type 2 diabetes mellitus. Microalbuminuria is common in type 1 diabetes mellitus of short duration, which is why testing in patients with type 1 diabetes mellitus should be started at 5 years of onset. After the initial screening test, and absence of microalbuminuria, the evidence should be repeated once a year.

Albuminuria (albumin excretion in urine) also may be temporarily increased by hyperglycemia (elevated blood glucose) of short duration, exercise, urinary tract infection, hypertension pronounced, heart failure and febrile illness.

Albumin excretion varies significantly from day to day, so before determining that a patient has microalbuminuria should be found high levels in at least 2 of 3 collections made over a period of 3 to 6 months.

Treatment

Control of glucose (sugar) blood. Intensive treatment of diabetes mellitus can significantly decrease your risk of developing microalbuminuria and overt nephropathy in patients with diabetes mellitus.

Blood Pressure Control

To reduce the risk and delay progression of nephropathy, we must optimize blood pressure control. At the onset of overt diabetic nephropathy, decrease the nutritional value.

One Response to “Complications The kidney and Diabetes”