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Diabetes and the Kidneys
Janice Lea, MD, MSc:
In the earlier stages of kidney disease, patients are often asymptomatic -- no symptoms at al. That’s why it’s crucial or very important for those patients to be monitored, because we can tell by their blood work and the urine tests if things are getting worse or progressing.
Lawrence Sanders, MD:
The kidney’s an organ that sits towards the back of your abdomen, just above your waist. It’s about the size of your fist and it actually looks a bit like your fist. It is responsible for maintaining fluid and mineral balance within the body. That’s the best way I know how to describe it.
It not only gets rid of water, excess waste products, and toxins, but it produces several hormones that regulate other organs. So, for example, it controls blood pressure. It secretes a hormone that regulates blood pressure and has some impact on the heart.
It is an organ that’s very much characterized by lots of blood vessels, both small and large. And it is the small blood vessels that the blood sugar or high glucose damages in the kidney that leads to kidney complications.
Some things in general people can do to stay healthy is to make sure they’re well hydrated, meaning that they drink lots of fluids. … There’s been some recent data within the last year or two that actually showed that chronic consumption or regular consumption of diet sodas actually impairs kidney function over the long term. It’s essential for all diabetics, especially if they have any degree of kidney dysfunction, that they consult with the dietitian or a nutritionist to go over their particular body’s needs. Patients with diabetes not only need to control their blood sugar, but they also need to control the blood pressure.
So when the blood pressure is high, the pressure inside the kidney is higher and the damage caused by the high glucose is greater.
When patients get to less than 10% kidney function they often have symptoms and will require dialysis treatment. And dialysis treatment is basically a replacement for the normal kidney function. So what it does is that it takes the blood out of the body, gives it to the machine, which cleanses it with a particular solution and takes out the bad things and returns the good things back to the patient. Kidney transplant is very effective if it’s done appropriately and patients are well matched, which is a rigorous process to make sure that happens.
The one thing that’s common here is the better you control your diabetes, the less likely you are to have complications from the diabetes.