Elevated blood sugar is harmful to the kidneys of diabetic nephropathy development. This is specific vascular lesion of kidneys in diabetes, in the final stage of which develops chronic renal failure.
For 20 years, every second patient with diabetes mellitus (I or type II) developed kidney disease of varying degrees.
The causes of kidney damage.
High blood sugar levels. The worse your blood sugar is controlled, the higher the probability of occurrence of diabetic nephropathy.
Hypertension.
Duration of diabetes. If the disease is longer, the risk of kidney damage is greater.
Violation of lipid metabolism (hyperlipidemia) leads to the deposition of atherosclerotic plaques, including those in the renal vessels, which also impairs their ability to filtration.
Smoking disrupts the blood vessels in the kidneys and increases blood sugar levels.
Genetic predisposition. There is a genetic predisposition to diabetic nephropathy.
How develops renal failure.
Kidneys with small blood vessels carry blood filtration in order to save nutrients and cleanse the body of toxins that are released in the urine. In the long-term elevated levels of sugar in the blood vessel walls kidney filters the burden on. This leads to a change in vascular permeability, and the body begin to be displayed and nutrients. The first starts to leave the protein albumin, initially in small quantities, so this is known as microalbuminuria (30 to 300 mg / day). This is the initial, asymptomatic stage renal disease, which over time becomes symptomatic form, which is manifested already a significant loss of protein. This stage is called macroalbuminuria or proteinuria.
Depending on the amount of protein allocated to distinguish several stages of proteinuria: mild proteinuria in the allocation of up to 1 gram of protein per day, the average degree – 1 to 3 grams of protein per day and heavy – more than 3 grams of protein per day.
Gradually, because of the disruption of the vascular wall permeability of kidney filters bad kidneys purify the blood and the blood begin to accumulate harmful substances. The next stage of diabetic nephropathy – chronic renal failure, which is characterized by the excretion of nutrients and harmful delays.
Treatment.
Treatment of diabetic nephropathy depends on the stage of clinical development process. But at every stage to conduct the following activities:
Compensation for blood sugar, focusing on the level of glycated hemoglobin and trying to make it no more than 6.5-7%;
Correction of lipid metabolism;
Diet with protein restriction and salt;
Reducing consumption or abstinence from alcohol.
Under conservative chronic renal failure, in addition, must:
With an increased number of precautions to comply with creatinine in the process of medicament therapy.
In particular, the dosage of metformin should be reduced. If possible, avoid the use of nonsteroidal anti-inflammatory drugs (they increase hypertension and worsening renal insufficiency) and the use of glibenclamide – it could provoke the emergence of severe hypoglycemia, hard-to-treat;
Carry out the correction of insulin;
Regularly check the level of hemoglobin in the blood – every 6 months.
In end-stageof renal disease using special methods of blood purification (hemodialysis, peritoneal dialysis) or kidney transplant.
See Also
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