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Tuesday, September 16, 2014
Quality Health Care and You - Diabetes
Protecting the Kidneys
How serious is protein in the kidneys of a type 2 diabetic and what can happen?
This is potentially a very serious problem. Protein in the urine is the first sign of progressive kidney disease in a diabetic. In its very earliest stage, it appears as a tiny amount of protein (or albumin) that is called "microalbuminuria" (i.e., microscopic amount of albumin in the urine). If detected at this early stage, the progression of diabetic kidney disease may be slowed, halted (and possibly even reversed) by the use of medications called angiotensin converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers (ARBs). If untreated, diabetic kidney disease can go on to produce much larger amounts of protein in the urine, followed by gradual kidney failure that eventually leads to "end stage renal disease" requiring dialysis.
Other factors that may help in the prevention and treatment of diabetic kidney disease are:
- Meticulous control of blood sugars
- Aggressive treatment of hypertension, especially with the drugs mentioned above (ACE inhibitors and ARBs)
- Treatment of hyperlipidemia (elevated blood cholesterol)
- Smoking cessation
- Weight loss
Diabetic kidney disease, often accompanied by hypertension and atherosclerosis, is the most common cause of kidney failure in the United States. Any diabetic with protein in the urine should be seen by a nephrologist (kidney specialist). Any treatment that is given for the kidneys - such as the ones listed above - will also benefit the rest of the body, particularly the cardiovascular system, and it is hoped that other complications of this disease may be prevented as well.
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University