Wednesday, January 19, 2022

Diabetes and the kidney!

Last week, we discussed the effects of diabetes on the eyes! The effects are undesirable as we said. Remember, we said decline in vision is the most common complaint and that the worst one can get from uncontrolled blood sugar is complete blindness! This week we discuss another important organ that usually gets affected badly by high blood sugar.

The kidney is a vital body organ. Some of the kidneys’ function is to regulate water balance in the body, removal of waste salts in the body. Kidneys filter different unwanted salts from the body to form urine. These are the very salts that give urine its unpleasant smell and some gold colour.

When kidneys fail, these salts accumulate in the body and water balance is seriously disturbed ÔÇô a feature that always causes shortness of breath and swelling of the face and the body in those with serious kidney failure.

What does high blood sugar really do on the Kidneys?

High blood sugar injures the kidney blood vessels and makes them so fragile that nutrients such as protein leak out of the blood into urine. Since these blood vessels are part of the filtration system, the salt and water control suffers too. The kidney then loses control of salts and water in the system.

What are the symptoms of diabetic kidney disease?

The signs of kidney diabetic disease are not very specific. It is a progressive disease though, which presents mainly as kidney failure. The mild form of this disease can be without any sign or symptoms. However, certain unspecific signs such as unexplained nausea and vomiting, loss of appetite, fatigue, headaches, general body itching, swelling of legs or face, shortness of breath, poor urine output should worry you.

However, certain signs, such as offensive urine, blood in urine, burning urine, frequent urination, and urgency to pass urine could mean infection or any other form of kidney disease that may also need to be looked into.

What investigations are useful for detecting kidney disease?

Urine analysis can give some light on how the kidneys are doing. Simple urine test can be done in the clinic to check if there are some proteins in the urine. Remember, earlier on we said uncontrolled high blood sugar causes damage to blood vessels and eventually proteins (nutrients) leak out of the blood stream. So these can be picked in the urine with a very simple test! However, this is a screen test and it could also miss some proteins, especially in the early phase of disease.

So the urine sample may need to be sent to the lab by your doctor to be checked by laboratory experts who will assist in giving more information about the urine and kidneys’ health. A blood test is also crucial since the function of the kidney can be checked by way of checking the levels of relevant waste salts.

Can it affect any one with diabetes?

Yes it can. The problem is the uncontrolled blood sugar that circulates and continues to damage the tiny blood vessels in the kidneys. As long as the sugar remains high in the blood, kidneys will get harmed. High blood pressure worsens the problem since it also injures the kidney directly.
What is the take home message then?

Please ensure that you screen yourself for diabetes and high blood pressure.

Good control of blood sugar and high blood pressure is crucial for slowing down kidney damage and, of course, eye damage as we said last week.

If the blood sugar and high blood pressure are uncontrollable on diet and physical activity, medications are worth taking.

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