6 expert tips on how to look after your kidneys if you have diabetes

Escrito por: Dr Jonathan Kwan
Publicado: | Actualizado: 20/12/2023
Editado por: Laura Burgess

It is predicted that by 2025 around five million of the UK population will suffer from diabetes. The health burden for specialists to manage patients with chronic diabetic kidney disease is likely to be high. Therefore, prevention and improving deterioration in patients already established with the disease is the correct strategy in going forward.

 

 

Currently, just under 20% of all patients needing life-maintaining dialysis have diabetes as the primary cause of their kidney condition. Every year, there will be some 1800 new patients who have diabetes joining this list. Prevention in diabetic kidney disease will bring both personal benefits to the patient and reduce the nation’s health expenditure in the medical management of these unfortunate patients.

 

The presence of a small amount of protein in the urine (microalbuminuria), in the absence of urine infection, is usually the first tell-tail sign of potential progressive diabetic damage to the kidneys. Most registered patients who have diabetes would normally go through an annual medical review with their GP, which includes urine testing to detect early presence of microalbuminuria. The presence of protein in the urine should target healthcare providers to optimise care to these patients and to halt, or slow down, their progressive disease.

 

Patients are able to prevent or halt kidney disease by adhering to the following:

 

Lifestyle modification

Look after the body by reducing body weight if obesestop smoking, avoid excess alcohol, cut down on salt to reduce fluid retention and blood pressure control, and try adopting a lifestyle with more exercise.

 

Watch your sugar intake

Optimise sugar control by working with diabetic doctors and nurses, aiming to maintain HbA1c, the three-month time-averaged sugar control marker, of below 7% (or in IFCC 53 mmol/mol, the new unit of measure.)

 

Blood pressure control

Optimise your blood pressure control with an aim to maintain BP < 140/80 mmHg, without undue dizziness. Your doctor may be able to advise on an even lower reading in certain clinical situations.

 

Blood pressure tablets

Use classes of blood pressure tablets that reduce systemic blood pressure, as well as the pressure inside the kidneys, ACEIs, ARBs and DRI. Your doctor will advise the appropriate agent.

 

Monitor cholesterol levels

Treat high cholesterol levels with statin if tolerated.

 

Take aspirin

Take low dose aspirin or other anti-platelet drugs where indicated.

 

These measures are the good practice management approaches of any patient who has diabetes even before they develop markers of kidney dysfunction; they also protect other organs in the patient too.

 

Good sugar control, good blood pressure control with the appropriate medications, and good cholesterol control will reap benefits not only in preventing kidney damage, but also reducing diabetic eye, heart, brain and nerve diseases.

Dr Jonathan Kwan

Por Dr Jonathan Kwan
Nefrología

El Dr. Jonathan Kwan es un nefrólogo muy respetado de Londres, que ha ganado varios reconocimientos nacionales, incluido el de Doctor en Medicina del Año en Innovación y Medicina Renal. Practicando en varias clínicas prominentes, sus intereses especiales incluyen todos los aspectos de la medicina renal, hipertensión, detección temprana de la enfermedad renal, infección renal, sangre y proteína en la orina, enfermedad renal crónica (ERC), enfermedad renal diabética y diálisis.

Después de graduarse de la Escuela de Medicina King's College a principios de la década de 1980, el Dr. Kwan completó la capacitación en Medicina Renal y Medicina General en algunos de los mejores hospitales docentes de Londres. Ha publicado más de 65 artículos revisados ​​por pares en varias revistas de alto impacto. Tiene una amplia experiencia clínica en el tratamiento de pacientes renales, con más de 20 años a nivel de consultor.

El Dr. Jonathan Kwan ha sido anteriormente Director Médico de los Hospitales Epsom y St Helier en Londres, y ahora, después de tomarse un año sabático para obtener experiencia internacional, el Dr. Kwan es Nefrólogo Consultor visitante en King's College Hospital y consultor Nefrólogo / Médico General en Darent Valley Hospital en Kent. Fuera de su clínica, se desempeña como Supervisor Educativo y Clínico de Health Education England.


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