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Can You Reverse Kidney Damage Caused By Diabetes?

High Blood Pressure And Diabetic Kidney Disease

High Blood Pressure And Diabetic Kidney Disease

High blood pressure (hypertension) is one of the principal causes of diabetic kidney disease and kidney failure. When blood pressure is high, there is a large amount of tension inside the blood vessels that leads to damage. These vessels may close off completely which can cause a heart attack, stroke, or kidney failure. High blood sugar and high cholesterol can also damage blood vessels. Thus people with diabetes who also have hypertension are at especially high risk for blood vessel damage. It usually takes years for blood vessels to completely close off and damage to blood vessels can be slowed down or reversed with treatment. Diagnosis Diagnosis of high blood pressure can only be done by having your blood pressure measured by a person trained in taking blood pressures. Usually, there are no symptoms that can tell you that you have high blood pressure. In diabetic patients the blood pressure is considered high if it is greater than 130/80. Your blood pressure should be measured on multiple occasions as blood pressures vary normally throughout the day and it is normal to have occasional high pressures. Blood pressure should be taken after you have rested for 5 minutes and may be taken sitting or standing. Your healthcare providers may ask you to check your blood pressure at home and record the readings as part of your blood pressure management. Treatment There are multiple ways to control your blood pressure. The first step is lifestyle changes. Most patients will also need one or several medications to achieve good blood pressure control. Lifestyle Changes Your diet and lifestyle can directly affect blood pressure. For example, too much salt, alcohol, or caffeine intake leads to your body increase your blood pressure. Your weight also affects your blood pressure. Incr Continue reading >>

Prediabetes? What Does It Mean For Your Kidneys?

Prediabetes? What Does It Mean For Your Kidneys?

Prediabetes describes the condition of someone who is on their way to developing diabetes. Before having diabetes, people usually have “pre-diabetes.” This is a new name for a condition in which blood glucose (sugar) levels are higher than normal but not yet high enough to be diagnosed as diabetes. A person with prediabetes cannot handle sugar as well as they should. Even though diabetes is not full blown, high sugar levels in prediabetes can be causing problems throughout the body. One of the main organs that can be damaged is the kidney. People with prediabetes often have unrecognized chronic kidney disease (CKD), according to new research. In this large study, more than one third of the people with prediabetes were found to have two signs of kidney disease: protein in the urine (called albuminuria). Albuminuria is not normal. reduced estimated glomerular filtration rate (eGFR). This is a measure of how well the kidneys work; the eGFR tells the stage of kidney disease. In the people with prediabetes, the stage of chronic kidney disease was just as advanced as people with diabetes. Many people with either prediabetes or diabetes were found to have stage 3 or 4 chronic kidney disease. There are 5 stages of chronic kidney disease. When the disease reaches stage 5, the person will need kidney replacement therapy, either transplantation or dialysis. The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or older—or 57 million people—have pre—diabetes. Without patients and their doctors taking action, prediabetes is likely to become type 2 diabetes in 10 years or less. People with prediabetes should know that the long—term damage to their body—especially to the heart, kidneys and blood vessels — may alread Continue reading >>

Tips On Reversing Diabetic Kidney Disease With Diet

Tips On Reversing Diabetic Kidney Disease With Diet

Kidney disease is a big problem amongst diabetics, and can be one of the main causes of kidney failure. The good news is that by making certain changes to your diet and lifestyle you may be able to prevent it, or if you already suffer from kidney disease, you might be able to reverse it. Please note that if you suffer from kidney disease, it is important to consult your doctor before making drastic changes to our diet and lifestyle, and that not all cases may be reversible. Tip 1 Cut back on high-protein meat as it makes the kidney’s workload much bigger. This is why low-protein diets are often recommended for people with serious cases of kidney disease. Tip 2 Eat small amounts of plant-based protein as these are a good source of essential amino acids, and they contain less protein than other sources. Good sources of plant-based proteins are nuts, tofu, peanut butter, and beans. Tip 3 Decrease your salt intake. Too much salt in your diet can mean higher blood pressure, which generally worsens kidney disease. Replace salt with salt-free herbs, spices, or lemon juice to add flavor when cooking. Tip 4 Keep potassium levels to a minimum to control your heartbeat. Higher potassium levels during heart disease may cause abnormal heartbeat, which affects various things like blood flow, blood pressure, and oxygen levels in the body. To help control potassium levels, increase your intake of fruits like grapes, cherries, berries, peaches, plums, apples, and watermelon. Certain vegetables like broccoli, carrots, cabbage, celery, cauliflower, lettuce, peppers, green beans, and zucchini. Tip 5 Kidney disease can cause your iron levels to decrease, so making sure you replace lost iron is vital. Include beans, lentils, white meat chicken, and other high-iron food into your diet. Tip Continue reading >>

Diabetic Nephropathy - Treatment Overview

Diabetic Nephropathy - Treatment Overview

Diabetic nephropathy is treated with medicines that lower blood pressure and protect the kidneys. These medicines may slow down kidney damage and are started as soon as any amount of protein is found in the urine. The use of these medicines before nephropathy occurs may also help prevent nephropathy in people who have normal blood pressure. If you have high blood pressure, two or more medicines may be needed to lower your blood pressure enough to protect the kidneys. Medicines are added one at a time as needed. If you take other medicines, avoid ones that damage or stress the kidneys, especially nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen and naproxen. It is also important to keep your blood sugar within your target range. Maintaining blood sugar levels within your target range prevents damage to the small blood vessels in the kidneys. Limiting the amount of salt in your diet can help keep your high blood pressure from getting worse. You may also want to restrict the amount of protein in your diet. If diabetes has affected your kidneys, limiting how much protein you eat may help you preserve kidney function. Talk to your doctor or dietitian about how much protein is best for you. Initial treatment Medicines that are used to treat diabetic nephropathy are also used to control blood pressure. If you have a very small amount of protein in your urine, these medicines may reverse the kidney damage. Medicines used for initial treatment of diabetic nephropathy include: Angiotensin-converting enzyme (ACE) inhibitors, such as captopril, enalapril, lisinopril, and ramipril. ACE inhibitors can lower the amount of protein being lost in the urine. Also, they may reduce your risk of heart and blood vessel (cardiovascular) disease. If you also have high blo Continue reading >>

Diabetes&its Link To Kidney Disease

Diabetes&its Link To Kidney Disease

Online Health Chat with Dr. Betul Hatipoglu and Dr. George Thomas Introduction Cleveland_Clinic_Host: Research shows that diabetes is the leading cause of kidney disease. In honor of World Kidney Day on March 10, 2011, the Glickman Urological & Kidney Institute and the Endocrinology & Metabolism Institute invite you to an online chat about diabetes and its link to kidney function. Join endocrinologist Betul Hatipoglu, MD, and nephrologist George Thomas, MD, online for answers to your questions concerning diabetes and kidney disease. Both Cleveland Clinic’s Glickman Urological & Kidney Institute and Endocrinology & Metabolism Institute are ranked in the top 10 nationally by U.S. News & World Report. Dr. Betul Hatipoglu is a staff member in the Department of Endocrinology, Diabetes and Metabolism at Cleveland Clinic's main campus, having accepted that appointment in 2008. Prior to that appointment, she was an assistant professor of medicine and medical director for the pancreas and islet cell transplant program at the University of Illinois at Chicago for nearly eight years. Her clinical interests include diabetes, thyroid disease in woman, pituitary and adrenal disorders, and alternative medicine. Dr. Hatipoglu received her medical degree from Istanbul Medical School. She completed an internal medicine residency and chief residency at Michael Reese-University of Illinois at Chicago, and an endocrinology fellowship at the University of Illinois at Chicago. Dr. Hatipoglu speaks three languages -- English, Turkish and French -- and is board-certified in internal medicine, as well as endocrinology, diabetes and metabolism. Dr. George Thomasis a staff member in the Department of Nephrology and Hypertension of the Glickman Urological & Kidney Institute at Cleveland Clinic. H Continue reading >>

Lithium And Chronic Kidney Disease

Lithium And Chronic Kidney Disease

What is lithium? Lithium is a common medicine used to help calm mood for treating people with mental disorders. Since such disorders need lifelong treatment, long-term use of lithium may be harmful to organs, such as the kidneys. How does lithium cause kidney damage? Lithium may cause problems with kidney health. Kidney damage due to lithium may include acute (sudden) or chronic (long-term) kidney disease and kidney cysts. The amount of kidney damage depends on how long you have been taking lithium. It is possible to reverse kidney damage caused by lithium early in treatment, but the damage may become permanent over time. What is nephrogenic diabetes insipidus? The most common problem from taking lithium is a form of diabetes due to kidney damage called nephrogenic diabetes insipidus. This type of diabetes is different than diabetes mellitus caused by high blood sugar. In nephrogenic diabetes insipidus, the kidneys cannot respond to anti-diuretic hormone (ADH), a chemical messenger that controls fluid balance. This results in greater than normal urine out-put and excessive thirst. It can be hard to treat nephrogenic diabetes insipidus. What are the signs and symptoms of kidney damage and nephrogenic diabetes insipidus due to lithium? When the kidneys are not able to control fluid balance you may notice: Greater than normal urine out-put (polyuria), along with greater than normal fluid intake (polydipsia) due to excessive thirst Getting up at night to urinate (nocturia) can be a sign of polyuria Signs of modest dehydration Low blood pressure while standing (orthostatic hypertension) Very fast heart beat (tachycardia) Dry mouth Signs of severe dehydration High blood sodium level (hypernatremia) Change in mental status Too much fluid loss can cause electrolyte imbalance. E Continue reading >>

Kidney Disease: Early Detection And Treatment

Kidney Disease: Early Detection And Treatment

Many Americans know nothing about kidney disease—until it's too late. "Unlike many diseases, kidney disease often has no symptoms until it is very advanced," says Andrew Narva, M.D., Director of the National Kidney Disease Education Program (NKDEP) a part of the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). "For this reason and others, it is important for people to not only become aware of their risk, but also to learn about the steps they can take to keep their kidneys healthier longer. An important step is to get tested." That testing is even more important for populations that are at higher risk for kidney disease, such as African Americans, adds Dr. Narva. Your doctor can do very simple tests to check for kidney disease: Measure the level of serum creatinine in your blood to estimate your glomerular filtration rate (GFR) Measure the level of protein in your urine (increased levels of protein show your kidneys are not working right) Check your blood pressure. How can you tell if you are at risk for kidney disease? Ask yourself these questions: Do you have diabetes (problems with your blood sugar)? Do you have high blood pressure? Do you have heart disease? Did your mother, father, sister, or brother have kidney disease? (Kidney disease runs in families.) If you answered "yes" to any of these questions, you are at risk for kidney disease. Now is the time to get tested. Your health care provider will order two simple tests to check your kidneys—a blood test to check your glomerular filtration rate (GFR) and a urine test to check for protein. GFR—A blood test measures how much blood your kidneys filter each minute, which is known as your GFR (glomerular filtration rate). This shows how well your kidneys are working. A GFR of 60 or Continue reading >>

Diabetic Nephropathy

Diabetic Nephropathy

Definition and Causes Diabetic nephropathy (DN) is typically defined by macroalbuminuria—that is, a urinary albumin excretion of more than 300 mg in a 24-hour collection—or macroalbuminuria and abnormal renal function as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filtration rate (GFR). Clinically, diabetic nephropathy is characterized by a progressive increase in proteinuria and decline in GFR, hypertension, and a high risk of cardiovascular morbidity and mortality. Prevalence and Risk Factors Diabetes has become the primary cause of end-stage renal disease (ESRD) in the United States, and the incidence of type 2 diabetes mellitus continues to grow in the United States and worldwide. Approximately 44% of new patients entering dialysis in the United States are diabetics. Early diagnosis of diabetes and early intervention are critical in preventing the normal progression to renal failure seen in many type 1 and a significant percentage of type 2 diabetics. In the United States, approximately 20.8 million people, or 7.0% of the population, are estimated to have diabetes, with a growing incidence. Roughly one third of this population, 6.2 million, is estimated to be undiagnosed with type 2 diabetes. The prevalence of diabetes is higher in certain racial and ethnic groups, affecting approximately 13% of African Americans, 9.5% of Hispanics, and 15% of Native Americans, primarily with type 2 diabetes.1, 2 Approximately 20% to 30% of all diabetics will develop evidence of nephropathy, although a higher percentage of type 1 patients progress to ESRD. Pathophysiology and Natural History The common progression from microalbuminuria to overt nephropathy has led many to consider microalbuminuria to define early or incipient Continue reading >>

Slowing Kidney Disease

Slowing Kidney Disease

You can have a good life with kidney disease—even if your kidneys fail. Having your kidneys work — even a little — can help you feel better and live longer. If you can slow your CKD, you can delay the need for treatment of kidney failure. The types of changes you might make to help your heart or the rest of your body will help your kidneys, too. Here are some things you can do — or avoid — to protect your kidneys: Keep Your Blood Sugar In The Target Range. High blood sugar harms blood vessels, including the nephrons in the kidneys. If you have diabetes, your doctor will give you a target for fasting blood sugar and for 2 hours after you eat. Test your blood sugar often to see how it changes based on what you eat and how active you are. Cut back on added sugars and refined carbs, like bread, cakes, and rice, if you have not done this yet. Take walks or find other ways to be active. Take your diabetes medicine(s) as prescribed. Keep Your Blood Pressure In The Target Range Your Doctor Gives You, Too. Even if your blood pressure was low your whole life, it may be high now — and, it may be hard to control. It is normal in CKD to need more than one blood pressure medicine. Check your blood pressure at home. Keep a log of the results so you can tell your care team when it is high or low and what time(s) you take your blood pressure pills. Talk with your doctor if you have side effects; a different medicine might work better for you. Exercise can help lower blood pressure, too. Lose Weight If You Are Overweight. The 10–year CARDIA study of young people (average age of 35) found that the more people weighed, the faster their kidney function fell. This was true even if they did not have diabetes or high blood pressure. It's hard to lose weight, but it can be done, a Continue reading >>

Bring In The Research Supporting The Blood Sugars You Want To Achieve Will Work.

Bring In The Research Supporting The Blood Sugars You Want To Achieve Will Work.

One of the worst things high blood sugars do to your body is that they slowly destroy your kidneys. Unfortunately, as is the case with so many "diabetic" complications, this organ destruction also appears to begin long before many people are given a diabetes diagnosis. The landmark UKPDS study found that one out of eight people diagnosed with diabetes already were leaking small amounts of protein into their urine. This symptom, called "microalbuminuria." is an early sign that kidneys have been damaged. Though there is no total agreement as to why this occurs, some factors that promote kidney damage are: 1. High blood pressure. When blood pressure is high, large protein molecules, including those that are glycosylated (covered with sticky excess sugar molecules) are pushed through the pores of the kidney's filtration units, damaging them. 2. High blood sugar. When normal glucose regulation fails, the kidneys must remove excess glucose from the blood, leading to high concentrations of glucose in the kidneys. These glucose molecules clog up tiny capillaries in the kidneys as they do those elsewhere in the body. Eventually this clogging destroys the glomeruli, the filtration units of the kidney. An eleven year study of over 1800 people with diabetes found a straight line relationship between the risk of developing chronic kidney disease and the A1c. The risk began to increase significantly when the A1c rose over 6.0%. Poor Glycemic Control in Diabetes and the Risk of Incident Chronic Kidney Disease Even in the Absence of Albuminuria and Retinopathy: Atherosclerosis Risk in Communities (ARIC) Study. Lori D. Bash et al. Arch Intern Med. Vol. 168 No. 22, Dec 8/22, 2008 Another study, that followed people with Type 1 diabetes for more than a decade found that those who had achi Continue reading >>

Treating Diabetic Kidney Disease

Treating Diabetic Kidney Disease

Because of the stress high blood sugar puts on blood vessels, diabetics have a strong likelihood of developing kidney disease. But maintaining control over your blood sugar can prevent this complication, which can become fatal if left untreated. In fact, controlling blood sugar can even reverse kidney problems for some diabetics. How is Kidney Disease Treated? The kidneys filter waste products out of the blood. Over time, diabetes can result in the kidneys filtering too much blood and eventually leaking protein into the urine, an early stage of kidney disease called microalbuminuria. When diagnosed early, kidney disease can be treated following many of the same steps involved in controlling your diabetes: • Eat a healthy diet comprised of fresh fruits and vegetables, whole grains and low-fat meats. • Take your insulin and other medications your doctor has prescribed. • Check your blood sugar levels regularly at home, and record the results. Talk to your doctor about how often to check your blood and what to do if your sugar levels start to get too high. You can take additional medications to help lower your blood pressure and treat kidney disease directly. Some options include: • Insulin or other medicines that lower blood sugar. • ACE inhibitors, such as Lopace (pamipril) or angiotensin II antagonist like Aprovel (irbesartan). These medicines are usually reserved for cases where a microalbuminuria has already been detected. • Blood pressure medicine if you suffer from high blood pressure. Diabetics with kidney disease should aim for a blood pressure level of 130/80 mm/hg or lower. • For end-stage kidney disease, you will need dialysis and, potentially, a kidney transplant. Reducing Kidney Damage Watching your diet and salt intake are essential to reducing Continue reading >>

Diabetic Kidney Disease Is Reversible:

Diabetic Kidney Disease Is Reversible:

Kidney disease, thought to be unstoppable in many people with type 1 diabetes, has been reversed with the help of nature, early detection, and tight blood sugar control. About a third of the 1.5 million patients with type 1 diabetes eventually need a kidney transplant, or must spend hours every other day hooked up to a dialysis machine. The new findings provide hope that, when diabetes is found early and treated aggressively, patients can avoid such drastic treatments. “In the earliest stages, we found that kidney injury is still a dynamic process that can either get worse or get better – even revert back to normal,” says Bruce Perkins, an endocrinology fellow at Harvard Medical School. Some 14.5 million other people, who suffer from the more common type 2 diabetes, also develop kidney problems. “Results from research on type 1 generally apply to type 2,” Perkins notes. “We assume that will be true in this case, but we won’t know until we do more studies.” The earliest sign of diabetic kidney disease is detection of small amounts of protein that leak from blood into the urine. Once it appears, doctors generally believe that it’s only possible to postpone, but not prevent, kidney disease. The research, done by Perkins and his colleagues at Joslin Diabetes Center in Boston, could change all that. Perkins and his colleagues studied 386 patients who had protein leakage into their urine for two years. They followed them for six more years and found that the disease reverses itself under certain conditions. The conditions included early detection and good control of blood sugar with insulin injections, as well as low blood pressure, cholesterol, and blood fats (triglycerides). “Surprisingly, the leakage of protein subsided in more than half (58 percent) of Continue reading >>

When Diagnosed Early, Stopping Diabetic Kidney Disease May Be Possible

When Diagnosed Early, Stopping Diabetic Kidney Disease May Be Possible

When Diagnosed Early, Stopping Diabetic Kidney Disease May Be Possible July 12, 2013 Dear Mayo Clinic: My father was recently diagnosed with diabetic kidney disease. Is there a chance this can be reversed, or will he have it for life? What changes, if any, should he be making to his diet? Answer: It is not uncommon for people who have diabetes to develop kidney problems. When diagnosed early, it may be possible to stop diabetic kidney disease and fix the damage. If the disease continues, however, the damage may not be reversible. Diabetic kidney disease, also called diabetic nephropathy, happens when diabetes damages blood vessels and other cells in the kidneys. This makes it hard for them to work as they should. In the early stages, diabetic kidney disease has no symptoms. That's why it is so important for people with diabetes to regularly have tests that check kidney function. In later stages of the disease, as kidney damage gets worse, signs and symptoms do appear. They may include ankle swelling, test findings that show protein in the urine, and high blood pressure. Over time, diabetic kidney disease can lead to end-stage kidney disease. If your father is in the early stages of diabetic kidney disease, there are several steps he can take to help protect his kidneys. First, it is critical to keep blood sugar as well controlled as possible. This not only helps the kidneys, but decreases the risk of other serious problems that can come from diabetes, such as blindness, heart attack and damage to the blood vessels and nerves. Keeping blood pressure under control also is important. High blood pressure can speed up the process of diabetic kidney disease and make kidney damage worse. In general, blood pressure of 140/90 in the doctor's office and 135/85 at home is a good g Continue reading >>

Diabetic Kidney Disease

Diabetic Kidney Disease

What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. What are other names for diabetic kidney disease? Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your blood glucose is too high blood pressure is too high African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and smoke don’t follow your di Continue reading >>

Chronic Kidney Disease

Chronic Kidney Disease

Chronic kidney disease (CKD) means that your kidneys are not working as well as they once did. Various conditions can cause CKD. Severity can vary but most cases are mild or moderate, occur in older people, do not cause symptoms and tend to become worse gradually over months or years. People with any stage of CKD have an increased risk of developing heart disease or a stroke. This is why it is important to detect even mild CKD. Treatment may not only slow down the progression of the disease, but also reduce the risk of developing heart disease or stroke. What is chronic kidney disease? Chronic kidney disease (CKD) means that your kidneys are diseased or damaged in some way, or are ageing. As a result, your kidneys may not work as well as they used to. So, the various functions of the kidney, as described in the previous section, can be affected. A whole range of conditions can cause CKD (see later). See separate leaflet called The Kidneys and Urinary Tract. Chronic means ongoing, persistent and long-term. It does not mean severe as some people think. You can have a mild chronic disease. Many people have mild CKD. CKD used to be called chronic renal failure but CKD is a better term, as the word failure implies that the kidneys have totally stopped working. In most cases of CKD this is not so. In most people who have CKD there is only a mild or moderate reduction in kidney function, which usually does not cause symptoms, and the kidneys have not 'failed'. What is kidney failure? Kidney failure means that your kidneys can't work properly. The two main forms are: Chronic kidney disease. Acute kidney injury (AKI) - this used to be called acute renal failure. It means that the function of the kidneys is rapidly affected - over hours or days. For example, the kidneys may go in Continue reading >>

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