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Kidney Disease of Diabetes – Treatment in India :
Nephrology (Kidney)
Kidney Disease of Diabetes – Treatment India offers information on Kidney Disease of Diabetes – Treatment in India, Kidney Disease of Diabetes – Treatment cost India, Kidney Disease of Diabetes – Treatment hospital in India, Delhi, Mumbai, Chennai, Hyderabad & Bangalore, Kidney Disease of Diabetes – Treatment Surgeon in India

Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of kidney disease, also known as nephropathy.

Diabetes is the most common cause of kidney failure, accounting for nearly 45 percent of new cases. Even when diabetes is controlled, the disease can lead to nephropathy and kidney failure. Most people with diabetes do not develop nephropathy that is severe enough to cause kidney failure. About 18 million people in the United States have diabetes, and more than 150,000 people are living with kidney failure as a result of diabetes.

People with kidney failure undergo either dialysis, which substitutes for some of the filtering functions of the kidneys, or transplantation to receive a healthy donor kidney. Most U.S. citizens who develop kidney failure are eligible for federally funded care. In 2003, care for patients with kidney failure cost the Nation more than $27 billion.

African Americans, American Indians, and Hispanics/Latinos develop diabetes, nephropathy, and kidney failure at rates higher than Caucasions. Scientists have not been able to explain these higher rates. Nor can they explain fully the interplay of factors leading to diabetic nephropathy—factors including heredity, diet, and other medical conditions, such as high blood pressure. They have found that high blood pressure and high levels of blood glucose increase the risk that a person with diabetes will progress to kidney failure.


Two Types of Diabetes

There are two types of diabetes. In both types, the body does not properly process and use food. The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body’s cells. To enter cells, glucose needs the help of insulin, a hormone produced by the pancreas. When a person does not make enough insulin, or the body does not respond to the insulin that is present, the body cannot process glucose, and it builds up in the bloodstream. High levels of glucose in the blood lead to a diagnosis of diabetes. Both types of diabetes can lead to kidney disease.
The Course of Kidney Disease

Diabetic kidney disease takes many years to develop. In some people, the filtering function of the kidneys is actually higher than normal in the first few years of their diabetes. This process has been called hyperfiltration.

Over several years, people who are developing kidney disease will have small amounts of the blood protein albumin begin to leak into their urine. At its first stage, this condition has been called microalbuminuria. The kidney’s filtration function usually remains normal during this period.

As the disease progresses, more albumin leaks into the urine. This stage may be called overt diabetic nephropathy or macroalbuminuria. As the amount of albumin in the urine increases, filtering function usually begins to drop. The body retains various wastes as filtration falls. Creatinine is one such waste, and a blood test for creatinine can be used to estimate the decline in kidney filtration. As kidney damage develops, blood pressure often rises as well.

Overall, kidney damage rarely occurs in the first 10 years of diabetes, and usually 15 to 25 years will pass before kidney failure occurs. For people who live with diabetes for more than 25 years without any signs of kidney failure, the risk of ever developing it decreases.


Effects of High Blood Pressure

High blood pressure, or hypertension, is a major factor in the development of kidney problems in people with diabetes. Both a family history of hypertension and the presence of hypertension appear to increase chances of developing kidney disease. Hypertension also accelerates the progress of kidney disease when it already exists.

In the past, hypertension was defined as blood pressure exceeding 140 millimeters of mercury-systolic and 90 millimeters of mercury-diastolic. Professionals shorten the name of this limit to 140/90 or “140 over 90.” The terms systolic and diastolic refer to pressure in the arteries during contraction of the heart (systolic) and between heartbeats (diastolic).

The American Diabetes Association and the National Heart, Lung, and Blood Institute recommend that people with diabetes keep their blood pressure below 130/80.

Hypertension can be seen not only as a cause of kidney disease, but also as a result of damage created by the disease. As kidney disease proceeds, physical changes in the kidneys lead to increased blood pressure. Therefore, a dangerous spiral, involving rising blood pressure and factors that raise blood pressure, occurs. Early detection and treatment of even mild hypertension are essential for people with diabetes.


Preventing and Slowing Kidney Disease

What are the possible complications?

What is the treatment for diabetic kidney disease?

Treatments that may be advised are discussed below. Treatments aim to: An angiotensin converting (ACE) inhibitor

There are several types and brands. These drugs work by reducing the amount of a chemical that you make in your bloodstream called angiotensin II. This chemical tends to constrict (narrow) blood vessels. Therefore, less of this chemical causes the blood vessels to relax and widen, and so the pressure of blood within the blood vessels is reduced. ACE inhibitors are drugs that are often used to treat high blood pressure. However, the way they work also seems to have a protective effect on the kidneys and heart. Therefore they help to prevent or delay the progression of the kidney disease.

An angiotensin-II receptor antagonist (AIIRA)

There are several types and brands. They work in a similar way to ACE inhibitors. One may be used instead of an ACE inhibitor if you have problems or side-effects with taking an ACE inhibitor. (For example, some people taking an ACE inhibitor develop a persistent cough.)

Good control of your blood glucose level

This will help to delay the progression of the kidney disease and to reduce your risk of developing associated cardiovascular diseases such as heart disease and stroke. Ideally, the aim is to maintain your HBA1c to less than 6.5%. See leaflets called Type 1 Diabetes and Type 2 Diabetes for details.

Good control of your blood pressure

Strict blood pressure control is likely to reduce the risk of developing cardiovascular diseases and prevent or delay the progression of kidney disease. Most people should already be taking an ACE inhibitor or angiotensin-II receptor antagonist (described above). These drugs lower blood pressure. However, if the blood pressure remains at 130/80 mmHg or more then one or more additional drugs may be advised to get the blood pressure to below this target level.

Limiting your dietary protein may be advised

Restricting the amount of protein in the diet has been shown to have a small effect at reducing the progression of the kidney disease in people with Type 1 diabetes. However, this is not routine treatment in primary care. The effect in people with Type 2 diabetes is debatable.

Other treatments to reduce risk factors

Other treatments that reduce the risk of developing associated cardiovascular diseases include:
Good Care Makes a Difference

If you have diabetes:
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