Kidney Disease Of Diabetes
Kidney Disease of Diabetes Facts* *Kidney Disease of Diabetes Facts Medically Edited by: Melissa Conrad Stöppler, MD Type 2 Diabetes Diagnosis, Treatment, Medication Medical Author: Melissa Conrad Stoppler, MD Medical Editor: Ruchi Mathur, MD, FRCP(C) Proper nutrition is essential for anyone living with diabetes. Control of blood glucose levels is only one goal of a healthy eating plan for people with diabetes. A diet for those with diabetes should also help achieve and maintain a normal body weight as well as prevent heart and vascular disease, which are frequent complications of diabetes. There is no prescribed diet plan for those with diabetes. Rather, eating plans are tailored to fit an individual's needs, schedules, and eating habits. A diabetes diet plan must also be balanced with the intake of insulin and oral diabetes medications. In general, the principles of a healthy diabetes diet are the same for everyone. Consumption of a variety of foods including whole grains, fruits, non-fat dairy products, beans, and lean meats or vegetarian substitutes, poultry and fish is recommended to achieve a healthy diet. Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of chronic kidney disease (CKD). Diabetes is the most common cause of kidney failure, accounting for nearly 44 percent of new cases. Even when diabetes is controlled, the disease can lead to chronic kidney disease and kidney failure. Most people with diabetes do not develop chronic kidney disease that is severe enough to progress to kidney failure. Nearly 24 million people in the United States have diabetes, and nearly 200,000 people are living with kidney failure a Continue reading >>
Effect Of Lisinopril On The Progression Of Renal Insufficiency In Mild Proteinuric Nondiabetic Nephropathies
Effect of Lisinopril on the progression of renal insufficiency in mild proteinuric nondiabetic nephropathies Division of Nephrology, University of Roma La Sapienza, Rome and Department of Nephrology S. OrsolaMalpighi Hospital, Bologna, Italy Search for other works by this author on: Division of Nephrology, University of Roma La Sapienza, Rome and Department of Nephrology S. OrsolaMalpighi Hospital, Bologna, Italy Search for other works by this author on: Nephrology Dialysis Transplantation, Volume 16, Issue 5, 1 May 2001, Pages 961966, Giulio A. Cinotti, Pietro C. Zucchelli; Effect of Lisinopril on the progression of renal insufficiency in mild proteinuric nondiabetic nephropathies, Nephrology Dialysis Transplantation, Volume 16, Issue 5, 1 May 2001, Pages 961966, Background. The aim of the study was to determine whether Lisinopril, an ACEinhibitor (ACEi), was more effective than other antihypertensive agents in slowing the progression of nondiabetic chronic renal diseases in patients with baseline proteinuria 1.0 g/day. Methods. In an open, multicentre study all eligible patients entered a 3 months runin phase during which antihypertensive therapy (with exclusion of ACEi) was adjusted in order to obtain a supine diastolic blood pressure 90 mmHg and urinary protein excretion and renal function stability were verified. One hundred and thirtyone patients with chronic renal insufficiency (Clcr between 2050 ml/min) because of primary renoparenchymal diseases and proteinuria 1.0 g/day, were randomized to Lisinopril (L=66) or alternative antihypertensive therapy (C=65). Changes in renal function were assessed by inulin (Clin) clearance. Results. During the followup period of 22.55.6 months, Clin did not change significantly in group L (1.310.6 ml/min/1.73 m2) differing signi Continue reading >>
Evidence For Kidney Protection From Lisinopril
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Evidence for kidney protection from Lisinopril I take the ACE inhibitor Lisinopril not because I have high blood pressure (which I don't) but because of the purported protective effects it has on my kidneys. However my GP doesn't know about that kidney protecting reasoning and just assumed I had high blood pressure; so does anyone know and have links to the studies that lead to that idea? I know many of us are on this drug (for ever) but as the advice on statins seems to be so way off the mark I wonder how good the evidence is for this other big seller? This systematic review aimed to assess the benefits and harms of blood pressure lowering agents in people with diabetes mellitus and a normal amount of albumin in the urine (normoalbuminuria) Fairly detailed summary but full text behind paywall. If you have microalbuminuria then there is strong evidence that it delays progression to macroalbuminuria 'In some studies, the beneficial effect of ACE inhibitors or ARBs appeared greater than the difference in mean follow-up blood pressure or persisted after adjustment for follow-up blood pressure in multiple regression analysis, suggesting that the benefit is due to mechanisms in addition to the antihypertensive effect.' Much like yourself Dillinger I didn't have high bp before taking Ramipril but with having diabetic retinopathy at the time it was suggested I started on them, the reason being that the lower the bp the less strain there is on the eyes which has been proven to help with retinopathy. I'm sure I've read that all bp drugs ending in 'pril' have beneficial effects for the kidneys, it makes sense to take one even at a low-dose if you think that you Continue reading >>
Prevention And Treatment Of Diabetic Renal Disease In Type 2 Diabetes: The Benedict Study
Abstract Diabetic nephropathy (DN) is the leading cause of end-stage renal failure in Western countries and carries an increased risk for cardiovascular mortality. Studies have identified a number of factors that play a part in the development of DN. Among them, hypertension and proteinuria are the most important. In the early stages of DN, when albumin is present in the urine in very low quantities (microalbuminuria) and an increase is seen in BP, there is no loss of filtrate and patients respond well to prophylactic measures. Microalbuminuria is considered an early marker of DN. Prevention of the onset of microalbuminuria, therefore, could be considered as the primary means of preventing DN. The Bergamo Nephrologic Diabetes Complication Trial (BENEDICT) was a prospective, randomized, double-blind, parallel-group study that was organized in two phases. Phase A included 1204 patients and was aimed at assessing the efficacy of the angiotensin-converting enzyme (ACE) inhibitor trandolapril, the non-dihydropyridine calcium channel blocker verapamil, and the trandolapril plus verapamil combination as compared with placebo in prevention of microalbuminuria in hypertensive patients with type 2 diabetes and normal urinary albumin excretion rate. Phase B was aimed at assessing the efficacy of the combination as compared with trandolapril alone in prevention of macroalbuminuria in patients with microalbuminuria. The BENEDICT Phase A study showed that DN can be prevented by ACE inhibitor therapy. The beneficial effect of ACE inhibition is not enhanced by combined non-dihydropyridine calcium channel blocker therapy. The apparent advantage of ACE inhibitors over other agents includes a protective effect on the kidney against the development of microalbuminuria, which is a major ris Continue reading >>
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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 >>
How To Protect Your Kidneys When You Have Diabetes
Reviewed by Michael Dansinger, MD When you have diabetes, it's key to take care of your kidneys. They do an important job filtering waste and removing it from your blood. Diabetes can hurt the kidneys and cause them to stop working. It's the main cause of kidney failure. How Diabetes Damages Kidneys With diabetes, you have high blood sugar. Those high levels make your kidneys work extra hard to filter your blood. Over time, working that hard can damage your kidneys, causing small amounts of protein to leak into your urine. Damage can get worse, and more protein leaks into your urine. Your blood pressure can start to rise. Waste materials will build up in your blood. If you don't treat it, your kidneys won't work anymore. If your kidneys fail completely, you'll need to have your blood filtered by a machine (dialysis) or have a kidney transplant. Can You Tell If You Have Kidney Damage? There are very few symptoms of kidney disease until your kidneys have almost stopped working. One of the earliest signs is fluid buildup. You might have swollen ankles, weight gain, or you may pee more often. You may also have a hard time sleeping or concentrating. You may not be hungry, or you may have an upset stomach. You may just feel weak. These symptoms aren't very specific. That's why it's important to see your doctor regularly for these kidney-related tests if you have diabetes. Blood pressure. High blood pressure can be a sign of kidney problems. You should have yours checked at every health care visit. Your doctor will tell you what levels are healthy for you. Blood tests. The estimated glomerular filtration rate (eGFR) checks how well your kidneys are able to filter your blood. Urine tests. Your doctor will check for levels of protein, creatinine, and albumin. These levels can sh Continue reading >>
The 10 Worst Medications For Your Kidneys
Did you know that there are certain medications out there that can cause forms of kidney damage? Don’t get me wrong, these medications can be life altering, and even life saving – but they are known to directly affect kidney function. Medications that can damage the kidneys are known as “nephrotoxic medications.” These drugs can cause direct toxicity to the kidneys, and have been implicated in up to 25% of acute kidney injuries. For people with even mild renal failure, you might want to think twice (or talk to your doctor) before you take these medications. NSAIDS, or nonsteroidal anti-inflammatory drugs, lead the list for medication induced kidney damage because of their widespread use. NDSAIDS are used to treat a host of conditions such as fever, rheumatoid arthritis, menstrual pain, and inflammation among many others. Use of NSAIDS like ibuprofen, naproxen, Motrin, Aleve, and Advil can reduce the amount of blood flow to the kidneys, resulting in a higher risk for kidney damage or failure. People with heart failure, liver disease, or previous kidney problems are at even higher risk when taking NSAIDS. To reduce the amount of risk associated with NSAID use, try to use these medications at the lowest effective dose for the shortest period of time. Vancomycin is an antibiotic used for the treatment of severe methicillin resistant staphylococcus aureus (MRSA) infections. Vancomycin has been known to cause kidney damage, and acute interstitial nephritis, or swelling in the kidney. When taking vancomycin, your levels should be closely monitored to help avoid kidney injury. Diuretics, sometimes called water pills, help your body release excess salt and water. These medications treat symptoms like blood pressure, glaucoma, and edema. There are three main types of diur Continue reading >>
Diabetic Kidney Problems
If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your kidneys. Your kidneys clean your blood. If they are damaged, waste and fluids build up in your blood instead of leaving your body. Kidney damage from diabetes is called diabetic nephropathy. It begins long before you have symptoms. People with diabetes should get regular screenings for kidney disease. Tests include a urine test to detect protein in your urine and a blood test to show how well your kidneys are working. If the damage continues, your kidneys could fail. In fact, diabetes is the most common cause of kidney failure in the United States. People with kidney failure need either dialysis or a kidney transplant. You can slow down kidney damage or keep it from getting worse. Controlling your blood sugar and blood pressure, taking your medicines and not eating too much protein can help. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>
Lisinopril For Type 2 Diabetes
by Med-World | Aug 18, 2015 | Learning Center I was recently diagnosed with type 2 Diabetes and put on several new medications because of it. One of the medications is Lisinopril. Upon doing my research, this seems to be a blood pressure pill, but I dont have high blood pressure. Could this be a mistake? Lisinopril is indeed primarily used as a blood pressure medication, but using it to treat diabetes is not a mistake. When a person develops diabetes they are at an increased risk of kidney problems, sometimes leading to chronic kidney disease. Lisinopril works specifically in the kidney by reducing constriction of the blood vessels surrounding it which helps benefit overall kidney function. These particular actions of Lisinopril are protective in nature. The ability of Lisinopril to protect the kidney reduces the risk of chronic kidney disease and slows the progression if there is existing chronic kidney disease. In fact, the American Diabetes Association says the addition of a blood pressure medication, such as Lisinopril, is the current recommended therapy for all patients who have been diagnosed with diabetes. With all that being said, your doctor is spot on! This weeks edition co-authored with Emma Siegmann, PharmD Candidate May 2016, SWOSU College of Pharmacy. Continue reading >>
Lisinopril User Reviews For Diabetic Kidney Disease At Drugs.com
Timthetoolman (taken for 6 months to 1 year) November 29, 2017 Did you? Yes No | Report inappropriate "My GP Doctor changed my blood pressure medicine from 5mg Amlodipine Besylate/50mg Metoprolol to 5mg Lisinopril/50mg Metoprolol to protect my kidneys. Over a forty day period my Lisinopril dosage was increased in stages from 5mg to 40mg in an attempt to get the same BP results I had with Amlodipine. Prior to taking Lisinopril my blood pressure was around 135/75. As the amount of Lisinopril was increased my blood pressure kept increasing. After 40 days it was around 175/85 (maximum 200/100). I take my blood pressure 3 -4 times per day. I experienced increased confusion, tiredness, dizziness, weakness and constipation as the dosage of Lisinopril was increased. I went back on Amlodipine and made an appointment with my Cardiologist." Jerrs (taken for 1 to 6 months) July 7, 2017 Did you? Yes No | Report inappropriate "I am male, 68, diabetic, 5'11 and 214 pounds. I have no blood pressure issues (I ride a bike about 60 miles per week). About three years ago my ankles started to swell showing a sock line in the morning. My new doctor thought it might be related to my kidney which lab tests showed was in the low end of normal.. My doctor prescribed 5mg of Lisinopril. Within two weeks the swelling disappeared. I do seem to have a little bit of a dry cough. I don't know if the cough is associated with the Lisinopril." Did you? Yes No | Report inappropriate "I have taken Lisinopril for years, 10 mg. Just recently my kidney doctor raised me to 20 mg. This did not work because it gave me diarrhea. So now they have changed me to losartan 50 mg. I am still having diarrhea. So now the doctor needs to figure out what to give me that will help my blood pressure but NOT give me diarrhea. Continue reading >>
About Lisinopril & Kidney Function
Shelly Morgan has been writing and editing for over 25 years for various medical and scientific publications. Although she began her professional career in pharmacological research, Morgan turned to patent law where she specialized in prosecuting patents for medical devices. She also writes about renal disease and hypertension for several nonprofits aimed at educating and supporting kidney patients. Lisinopril is often prescribed to kidney patients. Lisinopril is a commonly prescribed angiotensin converting enzyme (ACE) inhibitor. Although it is routinely given to patients with high blood pressure, it is also given to kidney patients without hypertension as a preventive measure. Understanding the connection between lisinopril and kidney function explains much about the benefits of this treatment. Regulation of blood pressure is important for everyone, but especially for kidney patients. Kidneys are almost entirely composed of vascular tissue. The tiny filters known as glomeruli form the largest portion of this tissue. Since glomeruli are nothing more than tiny capillaries, they can be easily destroyed by elevated blood pressure. Even in the absence of any other kidney disease, hypertension alone can destroy kidneys so it can be especially dangerous for patients whose kidneys are already compromised. Since lisinopril lowers blood pressure, it can play an important role in prolonging kidney function. The benefits of lisinopril go beyond just maintaining blood pressure. Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. Research has shown that ACE inhibitors have a kidney-protective effect that goes beyond the ability to control blood pressure. A 2001 study published in the journal Nephrology Dialysis Transplantation examined the effect of lisinopril on kidne Continue reading >>
Lisinopril (oral Route)
Lisinopril is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys resulting in a stroke, heart failure, or kidney failure. Lowering blood pressure can reduce the risk of strokes and heart attacks. Lisinopril works by blocking a substance in the body that causes the blood vessels to tighten. As a result, lisinopril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart. Lisinopril is also used to help treat heart failure. It is also used in some patients after a heart attack. After a heart attack, some of the heart muscle is damaged and weakened. The heart muscle may continue to weaken as time goes by. This makes it more difficult for the heart to pump blood. Lisinopril may be started within 24 hours after a heart attack to increase survival rate. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Portions of this document last updated: March 01, 2017 Copyright 2018 Truven Health Analytics Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Continue reading >>
Ace Inhibitors And Protection Against Kidney Disease Progression In Patients With Type 2 Diabetes: What's The Evidence?
ACE Inhibitors and Type 2 Diabetic Nephropathy How strong is the evidence that ACE inhibitors provide renal protection in patients with type 2 diabetes? Only a few, large-scale, randomized, well-controlled, multicenter studies have investigated whether ACE inhibitors delay the progression of renal disease in patients with type 2 diabetes,[ 6 , 10 ] and none of these studies have produced conclusive evidence of improvement in hard clinical end points ( Table ). Additionally, results from two smaller studies, that were placebo controlled and performed by the same group, demonstrated slowing in the rate of nephropathy progression from type 2 diabetes, but are inconclusive for ESRD development since they did not measure time to dialysis.[ 5 , 11 ] The following discussion categorizes these studies into those that demonstrated either positive or neutral findings compared with a control group. Positive Findings for ACE Inhibitors in Type 2 Diabetes. In a 7-year follow-up study of 94 normotensive patients with type 2 diabetes and microalbuminuria, Ravid et al.[ 5 ] showed that patients treated with enalapril maintained stable kidney function, expressed as reciprocal creatinine values, whereas kidney function in patients treated with placebo declined by 13%. Differences between the two treatment groups were significant from 2 years through the end of the study.[ 5 ] Similarly, in a study of 121 hypertensive patients with type 2 diabetes, Lebovitz et al.[ 7 ] showed that the rate of decline in GFR was significantly less in patients treated with enalapril compared with that in patients treated with conventional antihypertensive therapy (excluding ACE inhibitors).[ 7 ] However, the positive effect of enalapril on loss of GFR was seen only in patients with microalbuminuria (i.e., Continue reading >>
Does Lisinopril Really Protect The Kidneys
Does Lisinopril Really Protect the Kidneys Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Does Lisinopril Really Protect the Kidneys My doctor wants me to take Lisinopril. I'm reluctant b/c my blood pressure is already pretty low and I never had a problem with high blood pressure. My previous doctor never wanted to prescribe it b/c he said there is no proof whatsoever that this medication protects the kidneys, that they are still "studying" the possibility. Sometimes I wonder if the pharmaceutical companies aren't just looking to make a little more money. Anyway, I have refused to take it until there is proof that this actually protect the kidneys. I'm on a low dose of it, but my level of microalbumin in the urine was a little elevated, as was my BP. From what I've read, it's got a pretty good safety record and can protect the kidneys. However, I understand your reluctance to take it, given your BP being low already. My BP is now down (around 110/65 most of the time), but honestly I don't know if that's from the lisinopril or from my low-carb diet and big ol' weight loss. I'll stay on it for now, as I am not experiencing any of the side effects and my last urine test still showed increased microalbumin. I've been taking it for about 25 years - 10mg per day. When I started taking it, my endo said that it had a protective effect for the kidneys, and I have never had kidney issues. My BP has been slightly on the high side, but never really "high." I would think they would know for sure by now if it really does protect the kidneys, but I haven't read anything about that. ACE inhibitors have been used to help kidneys in diabetics since the 80s Continue reading >>
Protecting Your Kidneys
Diabetic nephropathy (kidney disease) is the leading cause of kidney failure in the United States. That’s the bad news. The good news is that the outlook for protecting your kidneys has gotten much brighter over the past decade or so. There are now a number of measures you can take that have been scientifically proven to protect your kidneys and lower the risk of developing diabetes-related kidney disease. Here’s what the research shows. When good kidneys go bad Your kidneys, which are each about the size of your fist, are located near the middle of your back, just below the rib cage. By no coincidence, they are shaped like kidney beans. One of their jobs is to filter waste products and extra water from the bloodstream. This waste and excess water, in the form of urine, flow through tubes called ureters and into the bladder. The bladder stores urine until it is full enough to create the urge to urinate. How does this filtering process work? Each kidney is made up of about one million tiny filtering units called nephrons. Tiny blood vessels called arterioles deliver blood to the nephrons. Within each nephron, the blood vessels form a complex called a glomerulus. It is within these glomeruli that the filtering activity actually takes place. The filtered blood leaves through another arteriole and is eventually carried back to the heart. Meanwhile, the material filtered from the blood passes through a tubule, where it is converted to urine, and then carried to the bladder through the ureters. (See “The Function of a Kidney” for more information about kidney anatomy.) Diabetes sets the stage for kidney damage. Chronic high blood glucose levels, often in combination with high blood pressure, damage the glomeruli and progressively diminish kidney function. (High blood Continue reading >>
