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Diabetes
and The Kidney
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Diabetes is the leading cause of
kidney disease around the world. Poorly controlled
diabetes, with time, leads to kidney problems. Most
of us fear kidney disease and instantly recall
images of dialysis or transplantation when kidney
disease is mentioned. In actual fact kidney disease
secondary to diabetes can easily be prevented and
even if already present can be usefully retarded or
suppressed.
Unfortunately many of us may have long standing
diabetes with little or no symptoms: the early
diagnosis of diabetes, long before complications
such as kidney disease take root is the first step
to preventing kidney disease. This is where
screening for diabetes becomes important. If you are
already a diagnosed diabetic, then strict blood
sugar control with regular monitoring of blood
pressure as suggested by your doctor will prevent
kidney disease. If you already have diabetic kidney
disease you will need to stop the progression of
these complications.
In kidney disease caused by diabetes, the kidney
begins to leak protein, which is excreted via the
urine. This urine protein can be detected by one of
several tests. These tests will be regularly
performed by your doctor, perhaps on an annual
basis. This only requires a urine sample and is
simple to perform and involves no risk to you.
Detecting kidney disease early, is the key to
arresting and controlling kidney disease. If these
simple tests become positive, you will be referred
on for a more comprehensive assessment.
Similar to diabetes in its early stages, kidney
disease too is without symptoms in the early stages.
In the later stages symptoms can include swelling,
tiredness, and changes in urine volume. Until
considerable damage is done to your kidneys, there
will be little or no symptoms. Regular testing at an
early stage will ensure that kidney complications
are picked up well in time. The earlier these
complications are detected, the more effective are
the steps taken to slow down or reverse kidney
disease. These include drugs to reduce the protein
leak in the urine as well as dietary changes to slow
the progress of the disease.
In Sri Lanka, many patients are first diagnosed to
have diabetes late in the illness, when
complications such as kidney disease have already
advanced considerably. This allows little
opportunity for preventive strategies.
With the introduction of screening programs we will
be able to detect diabetes early, giving the
opportunity for early detection of complications.
Patients who already have developed complications
have the opportunity to control these complications
before further damage can arise. This will have
considerable impact in preventing kidney disease
following diabetes.
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