China is a country with a high prevalence of diabetes in the world. Data shows that there are currently 140 million diabetes patients in China aged 20-79, which is equivalent to 1 diabetes patient for every 10 adults.
Diabetes is a chronic disease that is not inherently terrifying, while the truly frightening issues are the complications it can cause. In China, approximately 20% to 40% of diabetes patients develop diabetic nephropathy, which has become a major cause of chronic kidney disease and end-stage renal disease (uremia).
November 14th is "World Diabetes Day". How to prevent diabetic nephropathy and safeguard kidney health? The author conducted an exclusive interview with Dr. Hou Zeling from the Endocrinology Treatment Team in the Nephrology Department of Hainan Chengmei Hospital.
Why does diabetes tend to "disturb" the kidneys?
Dr. Hou Zeling explains that diabetes is a metabolic disorder characterized by high blood sugar levels. Prolong high blood sugar not only disrupts the bodys metabolism but also increases the burden on the kidneys. This can lead to glomerulosclerosis, impaired kidney function, and eventually kidney failure (uremia). When the kidneys are unable to function properly, patients may require dialysis treatment or undergo a kidney transplant surgery, which can impose a heavy burden on their lives and finances.
Meanwhile, diabetics often suffer from complications such as hypertension and high cholesterol. These conditions not only pose risks to cardiovascular health but also lead to renal artery sclerosis, resulting in a decrease in the glomerular filtration rate and impaired kidney function in terms of toxin and urine elimination. This can lead to symptoms such as proteinuria and ultimately trigger diabetic nephropathy.
How to identify early warning signs of diabetic nephropathy?
The progression from the discovery of diabetic kidney damage to the development of kidney failure is a lengthy process. If identified early and treated properly, diabetic nephropathy can be well-controlled.
Dr. Hou Zeling stated that many of the patients of them have neglected prevention and treatment of kidney disease. Combined with the lack of obvious early symptoms, patients often seek medical attention only when symptoms such as edema and hematuria appear. This delay in seeking medical treatment can result in serious consequences from minor conditions.
So, what are the danger signals of diabetic nephropathy, and how can it be prevented and treated?
Dr. Hou Zeling emphasizes that after being diagnosed with diabetes, it is important to undergo a "urine microalbumin/creatinine" test every 3-6 months, which serves as a crucial indicator for evaluating diabetic nephropathy.
Furthermore, it is crucial to be observant and take preventive measures in daily life.
The first symptom is an increase in foamy urine. When there is a significant amount of fine foam in the urine that persists for a long time, individuals with diabetes should pay attention and promptly seek medical attention to have their "urine microalbumin/creatinine" levels tested.
The second symptom is an increase in nocturia (frequent urination at night). Changes in nocturnal urine volume, such as frequently waking up to urinate more than twice or having nighttime urine volume exceeding one-third of the total daily urine output, should be observed. Increased nocturia is the early symptom of chronic renal insufficiency and can be diagnosed by measuring the blood creatinine level through a blood test.
The third symptom is edema The presence of eyelid and ankle swelling in the morning, and in severe cases, generalized edema, should be observed. Edema is one of the typical symptoms of diabetic nephropathy, primarily associated with hypoalbuminemia caused by significant protein loss in the urine. The albumin value can be measured through a blood test.
The fourth symptom is blurred vision. Diabetic nephropathy often occurs in conjunction with diabetic retinopathy. When a diabetic patient experiences visual impairment or blurry vision, it is important to conduct a comprehensive examination of kidney function.
The fifth symptom is hypertension When a diabetic patient develops hypertension, especially if it is higher or more difficult to control than before, it may be associated with the worsening of diabetic nephropathy.
Dr. Hou Zeling stated that early detection, early diagnosis, and standardized treatment are the most effective means of preventing and treating diabetic nephropathy. When a diabetic patient experiences symptoms as above , it is important to seek timely medical attention from endocrinology. Avoid delaying the diagnosis and treatment, as it may lead to a worse condition, more difficulty in treatment, and higher expenses.
How to reduce the risk of diabetic nephropathy?
Dr. Hou Zeling reminds that the first step is to control blood sugar, blood pressure, and blood lipids, as it is the foundation for preventing and controlling diabetic nephropathy. Diabetic patients should choose medications with protective effect on the kidneys and helping control blood sugar, blood pressure, and blood lipids within the target range under the guidance of an endocrinologist.
Secondly, it is important to avoid the excessive use of medications. Diabetic patients should take medications under the guidance of a doctor and should not misuse antibiotics, antipyretics, analgesics, or traditional herbal remedies.
Thirdly, it is important to develop good living habits and maintain a healthy weight. Diabetic patients should control their diet and take more exercise. They should control their daily calorie intake through diet, maintain a balanced proportion of fats, carbohydrates, and proteins, and prioritize the consumption of high-quality animal protein sources such as eggs, milk, and lean meats; They need to engage in exercises that are suitable for their cardiovascular and respiratory capabilities, such as brisk walking or cycling; Additionally, they need to maintain a regular sleep schedule and avoid smoking and alcohol.
Lastly, Dr. Hou Zeling recommends that diabetic patients should undergo follow-up examinations every 3 to 6 months to check their glycated hemoglobin, blood lipids, and urine microalbumin/creatinine levels. By regularly monitoring these physical indicators, they can take preventive measures in a timely manner and reduce the risk of developing diabetic nephropathy.
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