When people with diabetes experience kidney failure, they must undergo either
dialysis or a kidney transplant. As recently as the 1970s, medical experts
commonly excluded people with diabetes from dialysis and transplantation, in
part because the experts felt damage caused by diabetes would offset benefits of
the treatments. Today, because of better control of diabetes and improved rates
of survival following treatment, doctors do not hesitate to offer dialysis and
kidney transplantation to people with diabetes.
Currently, the survival of kidneys transplanted into people with diabetes is
about the same as the survival of transplants in people without diabetes.
Dialysis for people with diabetes also works well in the short run. Even so,
people with diabetes who receive transplants or dialysis experience higher
morbidity and mortality because of coexisting complications of diabetes—such as
damage to the heart, eyes, and nerves.
Good Care Makes a Difference
People with diabetes should
have their health care provider measure their
A1C level at least twice a
year. The test provides a weighted average of their blood glucose level for the
previous 3 months. They should aim to keep it at less than 7 percent.
work with their health care provider regarding insulin injections,
medicines, meal planning, physical activity, and blood glucose monitoring.
have their blood pressure checked several times a year. If blood pressure
is high, they should follow their health care provider's plan for keeping it
near normal levels. They should aim to keep it at less than 130/80.
ask their health care provider whether they might benefit from taking an
ACE inhibitor or ARB.
ask their health care provider to measure their eGFR at least once a year
to learn how well their kidneys are working.
ask their health care provider to measure the amount of protein in their
urine at least once a year to check for kidney damage.
ask their health care provider whether they should reduce the amount of
protein in their diet and ask for a
referral to see a registered dietitian to
help with meal planning.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Diabetic Neuropathy is a complication of diabetes that causes damage to the nerves; this is related to the blood glucose of the body being too high for a long period of time. The four types of neuropathy include peripheral, autonomic, proximal and focal.
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
The risks for developing type 2 diabetes include family history, ethnicity, birth weight, metabolic syndrome, and obesity. Warning signs pointing to an increased risk for developing type 2 diabetes include irregular menstruation, impaired fasting glucose, inflammatory markers, and other risks. Gestational diabetes is also a risk factor for developing type 2 diabetes later in life. Prevention of type 2 diabetes can be achieved through a healthy diet (Mediterranean diet), exercise, weight control, not smoking, and medication.
Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in situations such as illness, work, school, travel, or a natural disaster.
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