Nephropathy is one of the complications of diabetes, which happens approximate 15 years after the doctors have diagnosed diabetes. The explanation of its pathophysiology is simple.
There is one part of the kidney, which is damaged extremely hard. This part is called glomerulus and it is one of the most important parts of the kidney because without it, our blood will not be able to be cleaned out of the toxic and waste products of our cells.
In the state of nephropathy in diabetics, there is thickening of the glomerulus and it is not able to function properly.
One of the first symptoms, which can be detected by the doctors, is the increased amount of albumin, which is a protein commonly found in the blood, in the urine.
Usually, there is no protein of any kind in the urine. The presence of such proteins means that the glomerulus apparatus is damaged.
As the nephropathy progress, more glomerulus will be either destroyed or damaged by the sclerosis (the thickening process).
The symptoms that could be noted by the patients are many. Swelling is the first thing that they can see with their own eyes. The swellings are usually in the upper part of the body, especially around the eyes.
The specific time for them to appear is after night sleep. If you notice this, go to your doctor. Hiccups are also very common in diabetes nephropathy. Fatigue is very common symptom but it is not specific about the disease.
Arterial hypertension (hypertensive nephropathy), because the blood could not be filtered, due to destroyed glomerulus, is the symptom that patients can not see but they will feel.
Headache is the symptom that is in direct correlation with the increase of arterial pressure.
Moreover, because of this you will feel vomiting or/and nausea. These symptoms lead to increase arterial pressure. If your doctor is good and he/she knows that you have diabetes, he will do a kidney biopsy to confirm the diagnosis and because of that treatment could begin immediately.
Treating diabetes nephropathy is something very hard but with modern medicaments outstanding results are present.
Weapon of first choice is the group of medicaments known as ACE inhibitors. They stop the very important metabolic chain, which contributes to the increase of the arterial blood pressure.
In additon, ACE inhibitors have positive effect on the kidney, slowing down the progress of the disease.
These drugs reduce the hypertension. Diet must be modified to suit better to the patient’s need.
However, there has to be a strict control of the glucose level, as well as the serum creatinin. Protein intake also has to be modified in patients with diabetic nephropathy.
Written by Dr.Albana Greca Sejdini, Md, MMedSc
Medically reviewed by Dr.Ruden Cakoni, MD, Endocrinologist