Kidney Disease In Diabetics – Diabetic Kidney Disease Stages

Kidney Failure  

The kidneys act as a filtering system for waste products. This filtering system is made up of many tiny blood vessels which can be damaged by raised blood glucose levels, high blood pressure, and high cholesterol levels. If this damage continues to occur over a period of time, the kidneys stop working. Annual checkups lead to early discovery and prevention of Kidney Disease In Diabetics.

Kidney Disease Stages

Chronic kidney disease (CKD) refers to all 5 stages of kidney damage, from very mild damage in Stage 1 to complete kidney failure in Stage 5. The stages of kidney disease are based on how well the kidneys can do their job – to filter waste and extra fluid out of the blood. In the early stages of kidney disease, your kidneys are still able to filter out waste from the blood. In the later stages, your kidneys have to work harder to get rid of waste and may stop working altogether.


Stage 1 Kidney Disease

eGFR is greater than 90.

In Stage 1 kidney disease there is mild kidney damage, and usually no symptoms. If you have Stage 1 kidney disease, it is important to talk to your doctor about how to prevent your kidney damage from getting worse.

Most of the time an eGFR greater than 90 means the kidneys are healthy and working well. If you have Stage 1 kidney disease, this means you have other signs of kidney damage even though your eGFR is normal. Signs of kidney damage could be protein in your urine or physical damage to the kidneys.

Below are ways to slow kidney damage in Stage 1 kidney disease:

  • Control your blood sugar if you have diabetes.
  • Keep a healthy blood pressure.
  • Eat a healthy diet.
  • Do not smoke
  • Exercise 30 minutes a day, 5 days a week.
  • Keep a healthy weight.

Stage 2 Kidney Disease

eGFR between 60 and 89.

In Stage 2 kidney disease there is mild kidney damage, and usually no symptoms. If you have Stage 2 kidney disease, it is important to talk to your doctor about how to prevent your kidney damage from getting worse.

Most of the time an eGFR between 60 and 89 means the kidneys are healthy and working well. If you have Stage 2 kidney disease, this means you have other signs of kidney damage even though your eGFR is normal. Signs of kidney damage could be protein in your urine or physical damage to the kidneys.

Below are ways to slow kidney damage in Stage 2 kidney disease:

•    Control your blood sugar if you have diabetes.
•    Keep a healthy blood pressure.
•    Eat a healthy diet.
•    Do not smoke or use tobacco.
•    Exercise 30 minutes a day, 5 days a week.
•    Keep a healthy weight.


Stage 3 Kidney Disease

eGFR between 30 and 59.

Stage 3 kidney disease means the kidneys are moderately damaged and are not working as well as they should. Stage 3 kidney disease is separated into two stages; Stage 3a and Stage 3b. Stage 3a is an eGFR between 45 and 59. Stage 3b is an eGFR between 30 and 44.

Many people with Stage 3 kidney disease do not have any symptoms. But if there are symptoms, some of the more common ones are:

  • Swelling in the hands and feet
  • Back pain
  • Urinating more or less than normal

By Stage 3 kidney disease, you are more likely to have health complications as a result of waste building up in your body. Common complications from kidney disease are high blood pressure, anemia, and bone disease.

To keep your kidney disease from getting worse, follow the same steps for living a healthy lifestyle as in Stages 1 and 2. There are other things you can do in Stage 3 to keep your kidney disease from getting worse:

  • Visit a nephrologist to make a treatment plan that is right for you. Your nephrologist will tell you how often you will need to have your kidneys checked.
  • Meet with a dietitian, who will help you follow a diet that will keep you healthy.
  • If you have diabetes or high blood pressure, ask your doctor about special kinds of blood pressure medicines called ACE inhibitors and ARBs. Sometimes these medicines can help keep kidney disease from getting worse.

Stage 4 Kidney Disease

eGFR between 15 and 30.

Stage 4 kidney disease means your kidneys are moderately or severely damaged and are not working nearly as well as they should. Stage 4 kidney disease should be taken very seriously. It is the last stage of kidney disease before kidney failure.

By Stage 4 kidney disease, it becomes more common to have symptoms. Some of the more common symptoms are:

  • Swelling in the hands and feet
  • Back pain
  • Urinating more or less than normal

By Stage 4 kidney disease, you will likely have other health complications as a result of waste building up in your body. Common complications from kidney disease are high blood pressure, anemia, and bone disease.

To keep kidney disease from getting worse at this stage, there are steps that must be taken:

  • Have regular appointments with a nephrologist, to make a treatment plan that is best for you. Your nephrologist will tell you how often you will need to have your kidneys checked.
  • Meet with a dietitian, who will help you follow a diet that will keep you healthy.
  • If you have diabetes or high blood pressure, ask your doctor about special kinds of blood pressure medicines called ACE inhibitors and ARBs. Sometimes these medicines can help keep kidney disease from getting worse.

When you have Stage 4 kidney disease, this is the time to start talking with your nephrologist about how to prepare for kidney failure. Once your kidneys have failed, you will need to start dialysis or have a kidney transplant to live. You can start planning for dialysis or kidney transplant before you reach kidney failure.

  • Preparing for dialysis: There are several things you should consider when getting ready for dialysis. You will need to choose a type of dialysis, your vascular access type, and consider your finances and employment.
  • Preparing for transplant: If you are able to find a living kidney donor, you may not need to start dialysis at all. It is possible to have a transplant when your kidneys are getting close to failure. There are many things to consider as you prepare for a transplant.

Stage 5 Kidney Disease

eGFR less than 15.

Stage 5 kidney disease means the kidneys are getting very close to failure or have completely failed.

Stage 5 kidney disease has severe symptoms because the kidneys have usually stopped working. If your kidneys fail, toxins and wastes build up in your blood which makes you very sick.

Some of the symptoms of kidney failure are:

  • Itching
  • Muscle cramps
  • Nausea and vomiting
  • Not feeling hungry
  • Swelling in the hands and feet
  • Back pain
  • Urinating more or less than normal
  • Trouble breathing
  • Trouble sleeping

Kidney failure, also known as end-stage kidney disease, occurs when the kidneys are no longer able to adequately remove waste from your blood and control the level of fluid in your body. Kidney failure can happen suddenly or gradually. People with kidney failure need dialysis or a kidney transplant to stay alive.

The eGFR is a blood test that measures how well your kidneys filter waste from your blood. It tells how well your kidneys are working.

Your eGFR is a number based on your blood test for creatinine, a waste product in your blood. It tells how well your kidneys are working.

The eGFR is a good test, but it’s not right for everyone. For example, this test may not be accurate if you are younger than 18, pregnant, very overweight or very muscular. Talk to your doctor to find out if this test is right for you.

You will have a blood test to see how much creatinine is in your blood. Creatinine is a waste that comes from your muscles. Healthy kidneys take creatinine out of your blood.

Your doctor will figure out your eGFR using the result from your creatinine test, your age, your gender, and your race.


Dialysis For Kidney Failure

Dialysis artificially removes waste from your blood. There are two forms of dialysis – hemodialysis and peritoneal dialysis. Peritoneal dialysis is further broken down into two main types, continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD).
The choice of dialysis method depends on factors such as your age, health, and lifestyle.

Kidney Transplant

A kidney transplant is a treatment for kidney failure, but it is not a cure. A transplant offers a more active life and freedom from dialysis and restrictions on fluid and dietary intake. It is important to remember that a new kidney requires a lifetime of management and care.


Vitamins and Minerals in Kidney Disease

Are you getting enough vitamins and minerals for your health?  If you have kidney disease or kidney failure, here’s what you need to know.

They help your body use the foods you eat. They provide you with energy, help your body grow and repair tissue, and help maintain life.  Everyone needs them.  But if you have kidney disease or are on dialysis, you may not be getting enough.

Which supplements will I need to take?

Depending on your health and other factors, your healthcare provider may recommend some of the following supplements:

  • B Complex: B complex vitamins are grouped together, but each has a different job to do.
    • One of the important functions of vitamin B6, B12, and folic acid is to work together with iron to prevent anemia.  If you have anemia, it means you do not have enough red blood cells. Red blood cells carry oxygen from your lungs to all parts of your body.
    • Additional B vitamins, called thiamine, riboflavin, pantothenic acid, and niacin, can also be given as a supplement. These vitamins help to change the foods you eat into energy your body can use.
  • Iron: If you are taking medicine to treat anemia, you may also need to take an iron pill or have injectable iron. You should only take iron if your healthcare provider prescribes it for you.
  • Vitamin C: Vitamin C is used to keep many different types of tissue healthy. It also helps wounds and bruises heal faster and may help prevent infections. Your healthcare provider may need to give you a prescription for these vitamins.
  • Vitamin D: You may also need to take some vitamin D. It can be given as a pill and can also be given during your dialysis treatment if you are receiving dialysis. In addition to maintaining healthy bones, newer research shows that vitamin D may also protect against heart disease. There are different types of vitamin D. Your doctor will be very specific about the type and amount you should be taking. You should only take vitamin D if your healthcare provider prescribes it for you.
  • Calcium: Calcium along with vitamin D helps to keep your bones healthy. It is important to take only the amount of calcium prescribed by your doctor or dietitian. Too much calcium can clump together with phosphorus and deposit in places such as your heart, blood vessels, lungs, and other body tissues. If your blood phosphorus level is too high, you may need to take a medicine used to bind the phosphorus from your food. Some phosphorus binder medications contain calcium. They can give you extra calcium if you need it.

Which vitamins do I need to avoid if I have kidney disease?

You may need to avoid some vitamins and minerals if you have kidney disease. Some of these include A, E and K. These vitamins are more likely to build up in your body and can cause harm.  Over time, they can cause dizziness, nausea, and even death.  You should only take these vitamins if your healthcare provider gives you a prescription for them. There is also some concern about vitamin C.  Although some people may need to take a low dose of vitamin C, large doses may cause a buildup of oxalate in people with kidney disease.  Oxalate may stay in the bones and soft tissue, which can cause pain and other issues over time.

Conclusion: It is clear that diabetes can lead to kidney disease, but just why high blood sugars should damage the glomeruli (kidney vessels) is unclear. High blood pressure (hypertension) is a known risk factor for kidney disease and people with diabetes are prone to hypertension. The renin-angiotensin system – which helps regulate blood pressure – is also thought to be involved in the development of diabetic nephropathy.

Other risk factors include cigarette smoking. Diabetic nephropathy progresses steadily despite medical intervention. However, treatment can significantly slow the rate of damage. For supplements that can help protect your kidneys please view this post

Click here to read about how to improve diabetic kidney disease

Please leave any comments or questions below, I will try to respond within 24 hours

Thanks

Garry (Type 1)

Kidney Disease in Diabetes

 

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