What do we understand about diabetic kidney disease? Diabetic kidney disease or diabetic nephropathy is a common complication that occurs in approximately 30% of diabetics. In routine practice, it is detected quite late when it has already progressed to a point of irreversibility and it gradually progresses to end-stage renal disease (ESRD) requiring dialysis or transplant.

The functional unit of the kidneys is called nephron which is mainly divided into 2 parts glomeruli and tubules. The glomeruli are the main units of kidneys that are responsible for the filtration. In diabetics, glomeruli are the ones which are affected first. There is deposition of a lot of abnormal proteins in the glomeruli which leads to its malfunction. 

The initial manifestation of diabetic nephropathy is in the form of loss of protein in the urine (proteinuria). When the protein loss is limited and creatinine is normal, the condition is usually reversible. But once the creatinine starts rising, it becomes progressive and gradually reaches the stage of renal failure where it requires dialysis or transplant. 

How to detect it early. The easiest way to that is by doing a urine routine to check for loss of protein in urine and a serum creatinine. It is recommended for all type 2 diabetics to do a baseline urine routine and s.creatinine and then annual urine routine, regular BP checkup.

How to prevent it. The best way to treat any disease is to prevent it. First and foremost, you should prevent the risk factors in order to avoid coming down with Diabetic Nephropathy. The risk factors are high BP, high blood sugar, dyslipidemia and smoking. Intensive control of blood sugar according to studies, drastically reduces the risk of developing diabetic kidney disease. If you are diabetic, make it a point to get your regular checkups and maintain your diet to control your sugar. 

Other things that you must keep in your mind are to take proper medication that has been prescribed to you.  

The other most important factor is intensive control over blood pressure. Hypertension is common in patients who are diabetic. Hypertension alone can result in severe renal failure. Hypertension associated with hyperglycaemia (diabetes) is a major killer for your kidneys. Hence it is advised to keep your blood pressure under control.

Diabetic nephropathy is not something that would happen to every diabetic, so if you follow the above simple tips, the chances of the same would reduce. Many diabetics will get kidney failure due to causes other than diabetes and it may be treatable.In case you have a concern or query you can always consult a nephrologist and get answers to your questions!