How do kidneys work?



Our body produces "nitrogenous" wastes when it

metabolizes proteins; and these need to be removed from the blood. The kidneys operate as the filters that remove nitrogenous waste from the blood. As filters, they extract the wastes and return clean filtered fluid to the body. The kidneys are mostly made up of micro filters called glomeruli. When kidneys are functioning normally, the arteries bring

blood and wastes from the body into the kidneys, the

micro-filters clean the blood, and the wastes and extra fluid go out via the urine. Filtered and cleansed blood passes from the kidneys and returns into the bloodstream through the veins.

How can I prevent type 2 diabetes kidney problems?

All of the potential secondary problems that arise with

type 2 diabetes are due damage caused when blood glucose levels

are outside of the normal range. This is why it's

important to be vigilant in monitoring your blood glucose levels and keeping them close to normal as you can. If uncertain, ask your doctor what blood glucose levels are healthy for you.

Blood pressure is a key concern for diabetes sufferers. The kidney is basically a bank of micro filters; and like any other filter they are damaged if a fluid medium is squeezed through them under too much pressure. So, the next area to watch, to avoid kidney problems, is your blood pressure.

The aim is to keep your blood pressure below 130/80; and this will to help prevent renal damage. Again, ask your doctor what blood pressure range is best for you. If you are on regular blood pressure pills, take them as your doctor directs - it's important no to miss them. Other body parts or functions that will benefit from keeping your blood pressure regulated are your eyes, heart, and

blood vessels.

There are two principal kinds of kidney medications that will slow down kidney damage. These are :

· ACE (angiotensin converting enzyme) inhibitor

· ARB (angiotensin receptor blocker)

Do ask your doctor if you should be taking these

medications.

Diet can be a factor worsening kidney disease and slowing recovery. Your doctor or dietician will be able to help you work out a healthy dietary plan. If you have renal problems, they may suggest that you cut back on protein rich foods such as meat.

Regular Testing.

Regular testing of these secondary health problems is always part of the management of diabetes. You should have your kidneys checked at least annually. There is a urine test for the presence of small amounts of protein. This test is called the microalbumin test. There is a blood test for the presence of creatinine. The blood test is used to check your glomerular filtration rate (GFR). It tells you how those micro filters are performing, and is a basic measure of kidney function.

If you suffer from chronic pain, then you should be careful about taking painkillers regularly. Drugs like aspirin or acetaminophen can harm the kidneys. You've probably been

advised to take a daily dose of aspirin to protect the

heart; and that amount should be safe. Taking acetaminophen

for *occasional pain* should also be safe. But if you have

on-going pain, such as arthritis, you'll need

to work with your doctor to find a pain management strategy that doesn't put your kidneys at risk.

Urinary infections that occur from time to time pose a raised risk with diabetes, so do see your doctor right away if you develop any bladder or kidney infections. You hould suspect an infection if you have these symptoms:

·pain or burning when you urinate

·a frequent urge to go to the bathroom

·urine that looks cloudy or reddish

·fever or a shaky feeling

·pain in your back or on your side below the ribs

How can I protect my kidneys during special x-ray tests?

X-ray tests that use a contrast agent may pose a risk to

your kidneys. If you need to have x ray investigations , your doctor may recommend taking in extra water before and after the x rays to protect your kidneys. Or, alternately, your doctor may order a test that does not use a contrast agent.

How can diabetes damage my kidneys?

Kidney damage doesn't show symptoms early on. An early

diagnosis of kidney damage is when your kidneys leak

small amounts of a protein called albumin into the urine;

and this is why the regular urine test is recommended. As the kidneys become more damaged, they leak more and more protein. This problem is called proteinuria. With this disease, more and more wastes build up in the blood. As the damage progresses, the kidneys fail.

Diabetic nephropathy is the medical term for renal problems caused by diabetes; and nephropathy affects both kidneys at the same time.

What can I do if I have renal problems caused by diabetes?

Once you have kidney damage, you cannot undo it; but you can slow it down or stop it from getting worse. This is achieved by controlling your blood pressure, taking your ACE inhibitors or ARBs, and having your kidney function monitored regularly. However, if you are pregnant, you should not take ACE inhibitors or ARBs.

What happens if I get diabetes renal failure?

One way to treat diabetes kidney failure is with dialysis. Dialysis is a treatment that cleans your blood the way your kidneys used to do. There's two types of dialysis are available.

You and your doctor will decide what type will work best

for you.

1. Haemodialysis.

In haemodialysis, your blood is taken through a tube from

your arm to a dialysis machine that filters out the nitrogenous waste products and extra fluid. The clean blood flows back to your arm.

2. Peritoneal dialysis.

In peritoneal dialysis, your abdomen is filled with a

special fluid. The fluid absorbs nitrogenous waste products and the extra water from your blood. The dialysis fluid is then drained from your belly and discarded.

Another way to treat diabetes related kidney failure is to have a kidney transplant. The kidney can be from a close family member, perhaps from a friend, or even someone you do not know. It's all amatter of finding a good tissue match that your body will accept. Many people

are waiting for a kidney transplant, so you may be treated by dialysis for quite some time.

Summary

A program of diabetes care goes well beyond monitoring

blood glucose levels. Kidney disease is a condition that may occur with diabetes; and kidneys

problems don't necessarily show symptoms when kidney

failure is beginning. It's important to have blood and urine tests done annually to pick up first signs of kidney disease. There are a couple of medications (ACE & ARB) that will slow down kidney damage and help you to manage a good

health plan. There are treatments for more serious kidney failure. Keeping blood glucose levels regular is one of the best ways to protect your kidneys from secondary damage due to diabetes.