How to Treat Diabetic Nephropathy

Diabetic nephropathy is a kidney disease caused by diabetes, either type 1 or type 2. This disease is known as diabetic kidney disease. The longer a person has diabetes, the higher the risk of developing diabetic nephropathy. Then how to treat diabetic nephropathy? Before discussing the treatment, first need to know the cause and recognize the symptoms.

Diabetic nephropathy can affect the kidneys' ability to perform their function, namely removing toxins and excess fluid from the body. Over time, the condition can damage the filter system in the kidneys, cause kidney disorders, and even cause kidney failure.

The best way to prevent or delay diabetic nephropathy is to live a healthy lifestyle, and control blood sugar levels and blood pressure. Meanwhile, in people who have been diagnosed with diabetic nephropathy, treatment should be carried out early to prevent the condition from getting worse and reduce the risk of complications.

Causes of Diabetic Nephropathy

Diabetic nephropathy can occur when diabetes causes damage to parts of the nephrons. Nephron is the part of the kidney that functions to filter toxins and remove excess fluid from the body. Damage to the nephron causes the function of the nephron to be disrupted so that a protein called albumin can be wasted into the urine. In addition, the damage that occurs to the nephrons can also cause high blood pressure (hypertension) which further damages the kidneys.

Until now it is still not known why this condition can occur in people with diabetes. However, it is suspected that the damage has something to do with high blood sugar levels (hyperglycemia) and uncontrolled hypertension.

Apart from hyperglycemia and hypertension, there are several other factors that can increase the risk of developing diabetic nephropathy, namely:

• Smoke
• Suffering from high cholesterol
• Having excess weight (obesity)
• Having type 1 diabetes before the age of 20
• Suffering from other complications of diabetes, such as diabetic retinopathy or diabetic neuropathy
• There is a family history of diabetes and kidney disease

Symptoms of Diabetic Nephropathy

In its early stages, diabetic nephropathy is often asymptomatic. However, if kidney damage continues, the following symptoms will appear:

• Increased frequency of urination
• There is protein in the urine
• Loss of appetite
• Weight loss
• Nausea and vomiting
• Feeling weak
• Fatigue
• Difficult to concentrate
• Muscle cramp
• Swollen eyes
• Swelling in the legs and arms
• Dry and itchy skin
• Hard to breathe

How to Treat Diabetic Kidney Disease

If you experience symptoms of kidney disorders as mentioned above immediately check with a doctor. For diabetics, it is necessary to check with the doctor regularly according to the doctor's advice, so that kidney function can always be monitored.

From the symptoms experienced by the patient, the doctor can suspect diabetic nephropathy. However, to detect possible complications that arise, doctors need to perform a physical examination. In addition, to confirm the diagnosis, the doctor will need to carry out follow-up examinations to find out how well the kidneys are functioning. The follow-up examinations that will be carried out by the doctor include:

1. Blood Urea Nitrogen (BUN) Test

The BUN test aims to measure the level of urea nitrogen in the blood. Urea nitrogen is a metabolic waste substance that can normally be filtered by the kidneys and excreted along with urine. Normal BUN levels depend on age and gender. Here's the explanation:

• In adult men: 8–24 mg/dL
• In adult women: 6–21 mg/dL
• In children aged 1–17 years: 7–20 mg/dL

2. Creatinine test

The creatinine test aims to measure the level of creatinine in the blood. Like urea nitrogen, creatinine is also a waste of metabolic waste that is normally disposed of along with urine. Creatinine levels in men aged 18–60 years are normally in the range of 0.9–1.3 mg / dL, and for women it is in the range of 0.6–1.1 mg / dL .

3. Urine microalbuminuria test

Urine microalbuminuria tests are performed by randomly taking a sample of the patient's urine in the morning or a urine sample that is accommodated for 24 hours. If the patient's urine contains a protein called albumin then the patient can be suspected of suffering from diabetic nephropathy. The description of the urine microalbuminuria test is as follows:

• <30 mg, indicating that albumin levels in the urine are still in a normal state
• 30–300 mg (microalbuminuria), indicating that early-stage kidney disease is present
• 300 mg (macroalbuminuria), indicating that kidney disease is getting worse

4. Scan

Scans such as performing an ultrasound of the kidneys or X-rays can be done by the doctor to see the structure and size of the patient's kidneys. In addition, CT scans and MRIs can also be done to assess the condition of the kidneys in more detail.

5. Kidney biopsy

If needed, the doctor may also be able to take a sample of tissue from the patient's kidney (kidney biopsy). The sample was taken using a fine needle and then examined using a microscope.

Diabetic nephropathy cannot heal completely, but can be prevented from worsening it by controlling blood sugar levels and blood pressure. Methods of treatment for people with diabetic nephropathy are usually given medicines, such as the following:

• Insulin, to lower blood sugar levels
• ARB (angiotensin II receptor blocker) to lower high blood pressure while resisting the leakage of albumin into the urine or ACE inhibitor for angiotensin-altering enzyme inhibitors
• Statins, to lower cholesterol levels and reduce protein leakage into the urine (leaky kidneys)

In addition, the doctor will also recommend to patients to undergo a healthy diet, such as the following:

• Limiting salt or sodium intake to less than 1500–2000 mg/dL
• Limiting protein intake
• Limiting consumption of foods high in phosphorus such as milk, yogurt, and processed meats
• Limiting consumption of high-potassium foods such as spinach, bananas, and avocados

In patients with diabetic nephropathy who have experienced end-stage renal failure, the doctor may suggest renal replacement therapy to cleanse the blood of metabolic waste. Types of kidney replacement therapy can be in the form of dialysis using a machine (hemodialysis) every 2 to 3 times a week, dialysis through the stomach or peritoneal dialysis (CAPD), or undergoing a kidney transplant.

Complications of Diabetic Nephropathy

Complications due to diabetic nephropathy can develop periodically in a matter of months to years. Some complications due to diabetic nephropathy include:

• Diabetic retinopathy
• Hyperkalemia
• Anemia
• Pulmonary edema or fluid buildup in the lungs
• Erectile dysfunction
• Pregnancy complications
• Diarrhea
• Bone abnormalities
• Swelling in the hands, feet
• Open wounds on the legs

How to Prevent Diabetic Nephropathy

For diabetics, how to prevent diabetic kidney disease (diabetic nephropathy) can be by improving lifestyle through the following simple steps:

• For diabetics should do regular checkups, especially if accompanied by hypertension
• Maintain blood sugar levels to remain normal by routinely taking antidiabetic medicines as recommended by doctors, undergoing a healthy diet, exercising regularly, and getting enough rest
• Maintain ideal body weight, if you are obese then you must be able to lose weight
• Increase fiber intake from fruits and vegetables

That's an explanation of how to treat diabetic nephropathy and things related to diabetic nephropathy. Hopefully this explanation can be useful.