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March is National Kidney Month; diabetes is a leading cause of kidney disease

People who have diabetes and those who have a family history of diabetes are at risk of developing chronic kidney disease.
Diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body including your kidneys. It is a disease that can affect children as well as adults.
A significant portion of the population is currently afflicted with diabetes. There are probably many more people who have diabetes but do not even know it because the disease symptoms may be subtle. Also, many people have not had testing for the disease. The number of people with diabetes is also growing due in part to the epidemic of obesity in the United States. Add it all up and it becomes quite apparent that there are many people with diabetes and therefore many people at risk of developing kidney disease.
“We want people who have diabetes to know how important it is to take steps to protect and preserve their kidney function,” said Pawan Gupta, M.D., Nephrologist (kidney specialist) at Tyrone Hospital and member of the Board of Directors of the National Kidney Foundation of the Alleghenies.
The kidneys are powerful chemical factories that perform many essential functions. Some of their major functions include removing waste and excess fluid from the body, removing drugs from the body, balancing the body’s fluids, releasing hormones that regulate blood pressure, producing a form of vitamin D that promotes healthy bones and controlling the production of red blood cells.
“The kidneys affect the health of the body in many important ways,” said Dr. Gupta. “If the kidneys don’t function properly the performance of other body systems is affected and a person’s health deteriorates. It is a domino effect.”
How does diabetes affect the kidneys? With diabetes, the small blood vessels in the body are injured. “When the blood vessels in the kidneys are injured, your kidneys cannot perform properly. They cannot clean your blood properly and waste materials will build up in your blood. This can lead to serious health problems.” said Dr. Gupta.
Diabetes may also cause damage to nerves in your body. Dr. Gupta said nerve damage can cause difficulty in emptying your bladder.
The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. There is a lab test that is performed to check the albumin level. Dr. Gupta said it is important for diabetics to have this test on a yearly basis. “This allows doctors to catch changes early and intervene early.” Dr. Gupta said kidney disease is not reversible. But, there are treatments that can slow or halt kidney disease. That is why early detection is so important.”
Some early signs of kidney disease include weight gain and ankle swelling, the need to use the bathroom more at night, and an increase in blood pressure.
About 30 percent of children with Type 1 (juvenile onset) diabetes and 10 to 40 percent of people with Type 2 (adult onset) diabetes eventually will suffer from kidney failure, the most advanced form of kidney disease.
“The goal with early detection and early intervention is to prevent or postponed this advanced level of kidney disease,” said Dr. Gupta. “Those who are known diabetics, need to work closely with their physician and other health providers to keep their disease under control to protect their overall health and their kidneys.”
In cases of advanced kidney disease or in kidney failure, blood urea nitrogen (BUN) and creatinine levels in the blood will rise. Dr. Gupta said people with more advanced kidney disease may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in their legs) and anemia (a low blood count). Diabetics may also find they need less insulin.
“This is because diseased kidneys cause less breakdown of insulin,” said Dr. Gupta. “If a person with diabetes develops any of these signs, they should contact their doctor.”
End stage renal failure, or kidney failure, occurs when a person’s kidneys are no longer able to support them in a reasonably healthy state. Dr. Gupta said renal or kidney failure happens when the kidneys function at only 10 to 15 percent of their normal capacity. “The usual span of time between the onset of kidney disease in a person with diabetes and actual kidney failure is about five to seven years. This underscores the importance of early detection to protect and preserve the kidneys for as long as possible.”
The treatment for people with advanced kidney disease is dialysis or in some cases a kidney transplant.
The good news is there are things that can be done to slow or halt kidney disease when it is detected early. There are medications that can be effective and nutrition plays a role as well. Research suggests that a low-protein diet can slow the advance of kidney damage. People should follow their doctor’s recommendation about what treatments are most appropriate for their individual needs.
Dr. Gupta said the most important thing a person with diabetes can do to reduce their risk of kidney damage is to manage their diabetes and follow their doctor’s instructions about how to maintain their health. Good diabetes management generally includes monitoring blood glucose levels, controlling your blood pressure, and following any special diet recommended by your doctor and nutritionist.
The National Kidney Foundation of the Alleghenies will offer a free kidney screening through its Kidney Early Evaluation Program (KEEP) for people 18 years of age or older who are at risk for CKD. The screening will be held in the classroom at Tyrone Hospital on Friday, April 11 from 10 a.m. to 3 p.m. Those with diabetes, high blood pressure, chronic kidney disease or a family history of any of these medical conditions who wish to participate in the screening may make an appointment by calling the National Kidney Foundation at 1-800-261-4115.
Appointments are now being scheduled and are provided on a first come first served basis. A limited number of appointments are available.
The KEEP screening in Tyrone is made possible through the cooperative efforts of the National Kidney Foundation, Tyrone Hospital, and Pawan Gupta, M.D., Nephrologist on the Tyrone Hospital medical staff and member of the National Kidney Foundation of the Alleghenies Board of Directors.