Diabetic Kidney Disease (DKD) or Diabetic Kidney Disease is a serious chronic complication of diabetes that attacks the kidneys. Previously, DKD was known as Diabetic Nephropathy, and became a major problem when around 40% of diabetes patients eventually suffered from DKD which often required treatment with dialysis.
This condition occurs when high and uncontrolled blood sugar levels in the long term will trigger inflammation and chronic oxidative stress, causing impaired function of the blood vessel walls (endothelial dysfunction) with the result that it is easy to become blocked. In addition, inflammation and oxidative stress will also stimulate the formation of connective tissue that will damage kidney cells. Overall, all of these processes will interfere with the function of filtering dirt or toxins that should be removed through the kidneys, and can lead to permanent kidney failure.
Kidney disorders due to diabetes often develop without obvious symptoms in the early stages. Therefore, it is important for people with diabetes to really control their blood sugar levels well, in addition, it is also necessary to be vigilant so that they can prevent and detect DKD early so that it does not occur or worsen kidney function.
Causes and Risk Factors
Diabetic Kidney Disease can occur in diabetic patients with uncontrolled blood sugar levels. Some risk factors that can increase the likelihood of DKD include:
- Poor Blood Sugar Control
Uncontrolled blood sugar levels in the long term can damage the kidneys more quickly, increase the risk of DKD, and lead to permanent and serious damage to kidney function.
- Hypertension (High Blood Pressure) and High Cholesterol Levels
High blood pressure and high cholesterol levels can contribute to damage to the blood vessels in the kidneys, increase the workload of the kidneys, and worsen kidney function if not properly controlled through a healthy lifestyle.
- Smoking Habits and Unhealthy Lifestyle
Smoking (including vaping ) and consuming foods high in sugar and salt and saturated fats as often found in fast food and sweet drinks, being lazy to move or exercise regularly can damage the kidneys and/or worsen existing kidney damage in diabetes sufferers.
Symptoms of Diabetic Kidney Disease
In the early stages, patients often do not show any symptoms. However, as the blood sugar levels continue to be poorly controlled, several signs may appear that indicate the onset of kidney dysfunction, including:
- Swelling in the feet, ankles, or hands due to fluid buildup
- Uncontrolled high blood pressure
- Increased frequency of urination, especially at night
- Excessive tiredness and difficulty concentrating
- Nausea and vomiting due to waste buildup in the body
If these symptoms start to appear, immediately have an examination to prevent further complications and permanent kidney damage .
How to Prevent Diabetic Kidney Disease
Prevention of DKD can be done by maintaining overall health, especially for people with diabetes, especially by implementing a healthy lifestyle in everyday life. Here are some steps that can be applied, including:
- Good blood sugar control
Maintaining stable blood sugar levels can prevent kidney damage. Have regular check-ups, follow a healthy diet, and take medication as recommended by your doctor to control diabetes. There is no need to be afraid or hesitant to take anti-diabetic drugs prescribed by your doctor, because these drugs have been tested for their benefits and proven safe for diabetes patients.
- Managing Blood Pressure
Hypertension accelerates or worsens DKD. Maintaining stable blood pressure with a healthy diet, regular exercise, and avoiding stress can reduce the risk of kidney complications due to diabetes.
- Living a Healthy Lifestyle
A healthy lifestyle, in this case regulating food intake and exercising regularly, can help control blood sugar levels in diabetes sufferers, thereby preventing the onset or worsening of existing DKD.
Quit Smoking and Limit Alcohol Consumption because smoking can increase inflammation and oxidative stress, in addition, the alcohol contained in drinks is toxic to body organs including the pancreas and kidneys so that it can worsen blood sugar control which leads to the onset or worsening of DKD.
- Routine Kidney Check-ups
Regular kidney checkups are important for people with diabetes. Laboratory tests of urine and blood help detect kidney disorders early before they develop into more severe conditions. Doctors will usually advise people with diabetes to have regular blood and urine tests in diabetes patients to see the patient's response to the treatment given, and to detect organ damage including kidney damage in diabetes patients early.
Diabetic Kidney Disease Treatment
If a person has been diagnosed with diabetic nephropathy, some treatment steps that can be taken include:
- Control your blood sugar and blood pressure well. Make a balanced diet and take the necessary medications as directed by your doctor.
- Taking medications to protect the kidneys , such as ACE inhibitors or ARBs, can help reduce pressure on the kidney blood vessels and have benefits in reducing inflammation levels and oxidative stress by improving the body's sugar, fat and protein metabolism.
- Dialysis therapy or kidney transplantation , if the condition has entered the stage of kidney failure that requires assistance so that kidney function remains optimal through the dialysis process. The kidney transplantation process can also be performed on those who have experienced total kidney dysfunction, so that they have a new kidney organ that can function properly. However, it should be remembered that kidney transplantation is a complicated process and requires large costs, including post-transplant treatment that is full of challenges.
Protect Your Kidneys and Prevent Diabetic Kidney Disease Early
For those of you who have diabetes or are at high risk of kidney disorders, adopt a healthy lifestyle, take medication as directed by your doctor, and exercise regularly. If you experience suspicious symptoms, especially symptoms of kidney dysfunction as described above, do not hesitate to consult a doctor to get the right treatment as early as possible before kidney dysfunction or worsening of existing kidney function occurs.
Article written by dr. Wardhana, Sp.PD, KEMD, FINASIM (Internal Medicine Specialist - Endocrine, Metabolic & Diabetes Consultant, EMC Alam Sutera & Grha Kedoya Hospital).