From medriva.com
Diabetes, a chronic health condition affecting millions worldwide, quietly chips away at the body’s systems, including the kidneys, leading to a condition known as diabetic kidney disease or chronic kidney disease (CKD). About one in three adults with diabetes are living with CKD, a condition that can cause difficulty filtering waste and excess water from the blood. If left untreated, this condition can progress to kidney failure, necessitating a kidney transplant or dialysis. However, there are ways to mitigate the risk through early detection, appropriate treatments, and lifestyle modifications.
The Connection Between Diabetes and Kidney Disease
Diabetes is the leading cause of CKD and kidney failure. Chronic kidney disease (CKD) is characterised by the progressive and irreversible loss of kidney function. Symptoms can vary from fatigue, dizziness, high blood pressure, swelling in hands and feet, to urinary tract infections and protein or blood in urine. High blood pressure and diabetes are the most common causes of CKD. The risk of developing this condition is higher among older adults, people with a family history of kidney disease, and certain ethnic groups, including African Americans, Hispanic Americans, and Asian Americans.
Approximately one-third of diabetic patients progress to diabetic kidney disease (DKD), with early clinical manifestations such as microalbuminuria, progressing to macroproteinuria and a decrease in renal function. Pathological changes include thickening of the glomerular basement membrane, mesangial matrix expansion, Kimmelstiel-Wilson (K-W) nodules, and glomerulosclerosis. Some DKD patients, especially those with type 2 diabetes mellitus (T2DM), may have non-classical types of DKD, such as normoalbuminuric DKD, proteinuria-reduced DKD, and DKD with a rapid decline in renal function.
Reducing the Risk of Cardiovascular and Kidney Diseases
A study leveraging data from the TriNetX database found that the administration of SGLT-2is (sodium-glucose cotransporter-2 inhibitors) reduced the risk of cardiovascular and kidney diseases in patients with type 2 diabetes and AKD (Acute Kidney Disease). The use of SGLT-2is was associated with significant reductions in all-cause mortality, major adverse kidney events, and major adverse cardiovascular events compared to non-use.
Prediabetes and its Impact on Kidney Health
Research from the St. Jude Children’s Research Hospital indicated that childhood cancer survivors have twice the risk of developing prediabetes compared to the general public. Prediabetes increases their risk of life-threatening diseases, but this condition can be managed through lifestyle changes and medication to prevent its progression to diabetes and downstream conditions. Diabetes increases the risk of a heart attack event twofold and triples the risk of chronic kidney disease.
Managing Diabetes and Preventing Kidney Disease
Managing diabetes effectively requires a balance of healthy eating, regular physical activity, and medication. Limiting sugary drinks, portion control, and understanding the impact of different types of food on blood sugar levels are fundamental to managing diabetes. Regular screenings for CKD and managing other health conditions such as high blood pressure can prevent the progression to chronic kidney disease. In severe cases, treatment may include dialysis or a kidney transplant.
Prevention is always better than a cure, and this holds particularly true for diabetes and kidney disease. With the right lifestyle changes and early detection, the progression of the disease can be slowed or even halted, significantly improving quality of life for those with diabetes.
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