Diabetic kidney disease
Diabetic Kidney Disease (DKD)
Diabetic kidney disease (DKD), also known as diabetic nephropathy, is a serious complication of diabetes that affects the kidneys’ ability to filter waste and excess fluids from the blood. It is characterized by the gradual loss of kidney function and is a leading cause of end-stage renal disease (ESRD).
Causes and Risk Factors
DKD develops due to high blood sugar levels damaging the kidney’s filtering units (nephrons). Key risk factors include:
- Duration of Diabetes: Longer diabetes duration increases the risk.
- Poor Glycemic Control: Uncontrolled blood sugar levels exacerbate kidney damage.
- Hypertension: High blood pressure can further harm kidney function.
- Genetic Factors: Family history of kidney disease can predispose individuals.
- Lifestyle Factors: Obesity, sedentary lifestyle, and smoking can contribute to the risk.
Pathophysiology
The progression of DKD is often gradual, with initial stages showing no symptoms. As the disease progresses, the following changes may occur:
- Hyperfiltration: Initially, kidneys may filter more blood than normal due to increased blood flow.
- Microalbuminuria: Small amounts of protein leak into the urine, an early sign of kidney damage.
- Macroalbuminuria: As damage progresses, larger amounts of protein appear in the urine.
- Declining Glomerular Filtration Rate (GFR): Kidney function deteriorates, leading to decreased GFR.
- End-Stage Renal Disease: Severe damage leads to kidney failure, requiring dialysis or transplantation.
Diagnosis
Diagnosis of DKD typically involves:
- Urinalysis: To detect protein levels in urine.
- Blood Tests: To measure creatinine levels and estimate GFR.
- Imaging Studies: Ultrasound may be used to assess kidney size and structure.
- Biopsy: In some cases, kidney biopsy may be necessary for definitive diagnosis.
