Strict diabetes control helps to preserve the health of the kidneys and avoids serious complications over time
You have ? So yours deserve extra attention as they can be directly affected by the disease. What many people don’t know is that diabetes is the leading cause of chronic kidney disease (CKD) in the world. It is estimated that 4 out of 10 people with diabetes develop some degree of CKD. In Brazil, about 32% of dialysis patients have diabetes as a cause of renal failure, a number that may be even higher in some regions.
Why does diabetes harm the kidneys?
Diabetic nephropathy is a common complication in both type 1 and type 2 diabetes. Over time, poorly controlled blood glucose damages the blood vessels, responsible for blood filtering. In addition, high blood pressure, frequent in people with diabetes, accelerates this process.
The problem is that this kidney damage usually evolves slowly and silently. In most cases, there are no symptoms in the early stages, and many only discover the disease when it is already advanced – at a stage where dialysis may be inevitable. Therefore, the only way to early detect diabetic kidney disease is through regular blood and urine tests.
Early detection and diagnosis
Traditional diagnosis is based on the presence of proteins (albuminuria) in the urine and the evaluation of the estimated glomerular filtration rate (TFGE). Although this combination is still the pattern, studies show that in some patients the fall in TFGE may occur even without albuminuria. This reinforces the importance of regular monitoring.
Prevention and treatment of diabetic kidney disease
The good news is that diabetes -related kidney injury can be prevented or delayed with simple and effective measures:
- Strict blood glucose control: Maintain glycated hemoglobin (HBA1C) below 7%, adjusting the goal individually. In addition to metformin and insulin, medicines such as SGLT2 inhibitors (paragliflozin and dapagliflozine) offer proven kidney and cardiovascular protection.
- Blood pressure control: Preference for the use of medicines that block the renin-angiotensin system (such as losartan or enalapril) in patients with albuminuria or falling renal function.
- New therapies: Finereno, a non -steroid antagonist of the mineralocorticoid receptor, has shown to reduce the loss of protein in the urine and slow the progression of renal dysfunction.
- Lifestyle changes: Feeding with little salt, moderate protein restriction, regular exercise, abandonment of smoking and control of cholesterol and body weight.
Continuous follow -up: guarantee the health of the kidneys
Even if you feel good, it is essential to evaluate kidney function at least once a year if you have diabetes. Early detection and proper control of risk factors are the best strategies to avoid serious complications in the future and ensure quality of life.
Dra. Carlucci Ventura – CRM/SP 75746
Nephrologist, member of International Society of Nephrology
