At the community lecture, Aunt Zhang suddenly asked, "Doctor, does diabetes really cause kidney disease?" What tests should I do to prevent it? This question has aroused everyone's attention. Diabetes is a common chronic disease, and diabetic nephropathy (also known as diabetic nephropathy) is one of the most serious complications of diabetes. If not well controlled, it can indeed lead to kidney failure. Today, we will explore the relationship between diabetes and kidney disease in detail and introduce how to prevent it through laboratory tests.
The relationship between diabetes mellitus and kidney disease
The effects of diabetes on the kidneys
The hyperglycemic state caused by diabetes can cause damage to blood vessels throughout the body, and the kidneys are filled with tiny blood vessels. As a result, hyperglycemia can damage the blood vessel walls of the glomeruli, thickening them and ultimately affecting the glomeruli's filtering function. Long-term hyperglycemia can also lead to glomerulosclerosis, where the kidneys gradually lose their ability to filter blood, eventually leading to kidney failure.
Stages of diabetic nephropathy
The development of diabetic nephropathy can be divided into five stages:
Stage 1: glomerular hyperfiltration state. Glomerular filtration is elevated, and albuminuria is normal.
Stage 2: Early kidney damage. Urine albumin excretion begins to increase.
Stage III: Overt diabetic nephropathy. Urine albumin continues to increase, and trace amounts of albumin appear in the urine.
Stage IV: Clinical diabetic nephropathy. Albumin is excreted in the urine and serum creatinine and urea nitrogen are elevated.
Stage 5: End-stage renal disease. Kidney function is severely impaired and requires dialysis or kidney transplantation.
Risk factors for diabetic nephropathy
In addition to high blood sugar, the following factors can also increase the risk of kidney disease in people with diabetes:
High blood pressure: High blood pressure can increase the burden on the kidneys and accelerate the deterioration of kidney function.
Hyperlipidemia: dyslipidemia can lead to glomerulosclerosis.
Smoking: Smoking can damage blood vessels, further worsening kidney function.
Obesity: Obesity is associated with insulin resistance and increases the risk of kidney disease.
Family history: The risk is higher if you have diabetic nephropathy in your family.
The importance of preventing diabetic nephropathy
The importance of early prevention
The early stages of diabetic nephropathy are usually asymptomatic and once they reach the dominant stage, kidney function is severely affected. Therefore, early prevention and detection are key. Regular check-ups can help detect problems early, take effective measures to control the disease, and delay the progression of kidney disease.
Control your blood sugar
Keeping blood sugar stable in the normal range is the first step to prevent diabetic nephropathy. People with diabetes should strictly follow their doctor's advice to control their blood sugar and keep their blood sugar levels stable through diet, exercise, and medication management.
Control your blood pressure
The goal blood pressure for diabetic patients should be less than 130/80 mmHg. High blood pressure can put a strain on the kidneys, so controlling blood pressure is essential to prevent diabetic nephropathy. Antihypertensive drugs such as ACE inhibitors or ARBs are not only effective in lowering blood pressure, but also have a protective effect on the kidneys.
Healthy lifestyle
A healthy lifestyle is just as important to prevent diabetic nephropathy. Diabetic patients should maintain an appropriate weight and avoid obesity; Quit smoking and alcohol to reduce damage to blood vessels; Maintain a moderate amount of exercise, enhance physical fitness, and improve the body's immunity.
Laboratory tests that should be done in people with diabetes
Urine microalbumin test
Urine microalbumin test is one of the important methods for early detection of diabetic nephropathy. An increase in urinary microalbumin is an early marker of glomerular injury. An annual urine microalbumin test is usually recommended for people with diabetes to detect kidney problems in a timely manner.
Serum creatinine and urea nitrogen
Serum creatinine and urea nitrogen are important indicators of kidney function. Elevated serum creatinine levels indicate decreased kidney function, while urea nitrogen, a product of protein metabolism, is also closely related to kidney function. People with diabetes should have these markers tested regularly to monitor changes in kidney function.
Glomerular filtration rate (GFR) test
Glomerular filtration rate (GFR) is an important measure of the kidney's ability to filter. Decreased GFR is a marker of impaired renal function. Serum creatinine levels and other parameters can be used to calculate the GFR to help assess renal function.
Blood pressure monitoring
People with diabetes should monitor their blood pressure regularly to keep it in the normal range. High blood pressure can increase the burden on the kidneys and lead to further deterioration of kidney function. With regular blood pressure monitoring, antihypertensive medications can be adjusted in time to protect kidney health.
Lipid profile
People with diabetes are prone to dyslipidemia, such as high cholesterol and high triglycerides. These abnormalities increase the risk of cardiovascular disease and kidney disease. Regular lipid profiles can help patients take timely measures to control blood lipid levels and prevent kidney and cardiovascular diseases.
Practical measures to prevent diabetic nephropathy
Rational feasting
Diabetics should follow a diet low in salt, fat, sugar and fiber. Eat plenty of vegetables, fruits, whole grains, and high-quality protein, and avoid foods high in sugar, fat, and salt. Eating a reasonable diet can help control blood sugar, blood pressure, and blood lipids, and reduce the burden on the kidneys.
Exercise regularly
Moderate exercise is very important for diabetics. Exercise can help control blood sugar, improve insulin sensitivity, and lower blood pressure and blood lipids. It is recommended to do at least 150 minutes of moderate-intensity aerobic activity per week, such as brisk walking, swimming, or cycling.
Medication management
People with diabetes should take regular medications, including hypoglycemic drugs, antihypertensive drugs, and lipid-lowering drugs, as recommended by their doctors. Do not stop the drug or adjust the dose on your own. Regular follow-up visits, maintain communication with doctors, and adjust treatment plans in a timely manner.
Regular medical check-ups
Regular check-ups are an important measure to prevent diabetic nephropathy. Health problems can be detected early through medical check-ups and timely measures can be taken. People with diabetes should have a comprehensive physical examination at least once a year, including blood glucose, blood pressure, lipids, and renal function tests.
Quit smoking and limit alcohol
Smoking and drinking alcohol can cause damage to blood vessels and kidneys. Diabetics should quit smoking, reduce alcohol consumption, protect vascular health, and reduce the risk of kidney disease.
Treatment and management of diabetic nephropathy
drug therapy
Drug treatment for diabetic nephropathy mainly includes drugs to control blood sugar, blood pressure, and blood lipids. ACE inhibitors and ARBs are not only effective in lowering blood pressure, but also have a renal protective effect. For people with dyslipidemia, statins may be used to lower cholesterol levels.
Dialysis treatment
Dialysis may be needed when diabetic nephropathy progresses to end-stage renal disease and kidney function is severely impaired. Dialysis can help remove waste and excess fluid from the body and keep the body functioning properly. Common dialysis modalities include hemodialysis and peritoneal dialysis.
Rib transplant
For people with end-stage renal disease, a kidney transplant is an effective treatment. With a kidney transplant, patients can regain better kidney function and improve their quality of life. However, kidney transplantation requires matching with a suitable donor, and anti-rejection drugs need to be taken for a long time after surgery to prevent rejection.