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Diabetic Nephropathy – A Kidney disease

Diabetic nephropathy is kidney disease that develops as a result of diabetes mellitus(DM), also called diabetes. This disease damages many organs, including the eyes, nerves, blood vessels, heart, and kidneys. DM is the most common cause of kidney failure in the United States and accounts for over one-third of all patients who are on dialysis.
Each kidney is made of hundreds of thousands of filtering units called nephrons. Each nephron has a cluster of tiny blood vessels called a glomerulus. Together these structures help remove waste from the body. Too much blood sugar can damage these structures, causing them to thicken and become scarred. Slowly, over time, more and more blood vessels are destroyed. The kidney structures begin to leak and protein (albumin) begins to pass into the urine.

* Fatigue.
* Foamy appearance or excessive frothing of the urine.
* Frequent hiccups.
* Generalized itching and ill feeling.
* Headache, nausea and vomiting.
* Poor appetite.
* Swelling of the legs, around eyes, body swelling in later stage of disease.
* Unintentional weight gain (from fluid buildup).

What causes diabetic nephropathy?
Hypertension, or high blood pressure, is a complication of diabetes that is believed to contribute most directly to diabetic nephropathy. Hypertension is believed to be both the cause of diabetic nephropathy, as well as the result of damage that is created by the disease. As kidney disease progresses, physical changes in the kidneys often lead to increased blood pressure.

A higher proportion of individuals with type 2 diabetes are found to have microalbuminuria and overt nephropathy shortly after the diagnosis of their diabetes, because diabetes is actually present for many years before the diagnosis is made and also because the presence of albuminuria may be less specific for the presence of diabetic nephropathy, as shown by biopsy studies.

Screening for microalbuminuria can be performed by three methods:
– Measurement of the albumin-to-creatinine ratio in a random spot collection.
– 24-h collection with creatinine, allowing the simultaneous measurement of creatinine clearance.
– Timed (e.g., 4-h or overnight) collection.

Specific treatment for diabetic nephropathy will be determined by your physician based on:
* your age, overall health, and medical history.
* extent of the disease.
* your tolerance for specific medications, procedures, or therapies.
* expectations for the course of the disease.
* your opinion or preference.
Treatment may include any, or a combination of, the following:
* proper diet.
* exercise.
* strict monitoring and controlling of blood glucose levels, often with medication and insulin injections.
* medication (to lower blood pressure).

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