by Marshaneil Soumi D’ Rozario | 13th March, 2019
World Kidney Day is annually celebrated on 14th March. It is observed to create health awareness globally about the importance of your Kidneys and the impact of Kidney Disease in life. The Kidneys are responsible for many essential regulatory roles, including filtering the blood to keep it clean and chemically balanced,and for the production of a hormone called erythropoietin. One of the most important is the removal of waste products from the blood, which comes from food, and the normal breakdown of active tissues, such as muscles. The kidneys also produce hormones that support the function of other organs in the body, including hormones erythropoietin that supports the production of healthy red blood cells. Dr. Pradeep Gadge, a leading Diabetologist, Gadge Diabetes Centre, elaborates on the importance of Kidneys in Diabetes.
The Kidneys have a key role in maintaining the glucose homeostasis. It is adversely affected by hyperglycemia and insulin resistance in the setting of diabetes mellitus. Although the liver is commonly viewed as being largely responsible for the increased release of glucose in diabetic patients, the Kidneys also increase the release of glucose into the circulation in the fasting state. Normally each day, approximately 180 g of glucose is filtered by the Kidneys.
Diabetes and Hypertension have become the most common causes of ESRD (End Stage Renal Disease). Diabetes is a metabolic disease that causes renal failure, and renal failure increases the need for insulin in diabetic patients. High blood sugar levels damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage kidneys.
The greatest risk of low blood sugar occurs in someone who has both Chronic Kidney Disease (CKD) and Diabetes. When kidney function declines, insulin and other diabetes medications remain in the system longer because of decreased kidney clearance. Sometimes patients may experience a loss of appetite that can lead to skipping meals or not eating enough. This often causes a drop in blood sugar levels. Your doctor will customize the dose and timing of medications to go with the Diabetes and CKD patient’s daily routine and meal plan. Also, if a patient is on dialysis, they need to check their blood sugar more often.
• Unfortunately, the problem with Kidney Disease is that it remains symptom free for long, and when symptoms occur, it is usually too late to intervene. Only early screening and detection of Kidney Disease helps.
• One can suspect the onset of Kidney Disease if there is swelling -especially around the ankles and around the eyes, and frothy urine. It indicatesloss of protein in urine.
• As the disease progresses, the person becomes weak, anaemic, finds it difficult to concentrate, gets exhausted easily, develops loss ofappetite, has nausea and vomiting.
• As Kidney Disease advances, the bones become brittle and can easily break.
• Kidney Disease can be picked up easily by simple blood and urine tests. The Urine Test will reveal protein loss and blood will show rise in urea and creatinine.
The measures a diabetic patient needs to take to protect against Kidney Disease, include:
• Strictly avoid painkillers (NSAIDs & Cox 2 inhibitors)
• Take care to avoid dehydration (vomiting and diarrhoea)
• Control your diabetes and blood pressure
• Taking kidney protective medicines
• Avoid alcohol, smoking and tobacco
• Alter your Insulin dose with your doctor’s advice if you have loss of appetite.
• Take safe painkillers if required (plain paracetamol)
• Avoid using emulsion gels and spray that contains NSAIDs
Check your kidney functions if you have one or more of these 'high risk' factors:
• Family history of Kidney Disease
In conclusion, Dr Pradeep Gadge, a leading Diabetologist, Gadge Diabetes Centre, adds, “The most common painkillers are diclofenac and aceclofenac, which people tend to take continuously. Long term ingestion of these pain killers leads to Kidney Disease. Diabetic patients are always recommended whenever they are visiting their doctors, that they should inform their doctors about their creatinine levels.”
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