How are Diabetes Mellitus and Kidney Related?

Diabetes Mellitus (DM), the commonest form of diabetes can affect kidneys in several ways – it can predispose to urinary tract infection, it can cause the reduced blood supply to the kidney by narrowing of the blood vessels supplying the kidneys and it can cause the death of a part of the kidney called papilla. Most importantly it can interfere with the function of filters within the kidneys (called glomeruli) resulting in progressively increasing protein leak in urine (proteinuria) and irreversible loss of kidney function over a period of several years (diabetic nephropathy). All these effects can lead to Chronic Kidney Disease (CKD). Rest of the discussion will focus predominantly on diabetic nephropathy as it is the commonest kidney involvement in DM.

How common is kidney failure due to diabetes mellitus?

DM is the commonest cause of CKD all over the world (and in India too). Around one-third of patients on dialysis for CKD have DM; also one third of patients having DM develop CKD.

How long does it take to cause kidney disease?

DM takes a minimum about 5 – 7 years to affect the kidney. The diagnosis of DM may be delayed if it is silent or not associated with the symptoms at the beginning; often we see patients with shorter duration of DM developing CKD related to DM.

What are the symptoms of kidney problem in a diabetic?

The early symptoms of kidney involvement in a diabetic patient are froth in urine and swelling of face, legs and abdomen. With worsening in kidney function, patients may have reduced urine output, increase in blood pressure, and loss of appetite, vomiting, tiredness, breathlessness and frequent episodes of low sugar (hypoglycemia). BUT PLEASE BE AWARE that the kidney involvement in a diabetic patient can be silent and all patients with DM should undergo periodic screening for urine and blood testing for proteinuria and serum creatinine. Diabetic eye disease (Diabetic Retinopathy) is invariably associated with diabetic nephropathy and patients who have diabetic retinopathy should undergo urine and blood tests for kidney disease.

How do you detect kidney damage?

Normally there is no protein leak in urine and the routine urine test will report this finding as nil or trace protein; DM over a period of years can cause closure of capillary loops within the filter units resulting first in progressively increasing proteinuria and subsequently progressive reduction in kidney function (kidney function can be calculated with certain mathematical formulae that require estimation of serum creatinine). It is possible to diagnose kidney involvement in DM at the earliest stage by doing urine test for microalbumin – this test will detect the presence of smallest quantities of albumin (a form of protein) even before routine urine test can detect its presence in urine.

What are the treatment options available once severe kidney failure happens?

Dialysis and Renal Transplantation are the available treatment options for patients with advanced CKD. There are two forms of dialysis: Hemodialysis (HD) and Continuous Ambulatory Peritoneal Dialysis (CAPD).

Things You Need to know About Thyroid Cancer

Your thyroid is in the shape of a small butterfly, and is usually found inside the lower front of your neck. It’s a gland that controls your metabolism. It also releases hormones that direct many functions in your body, including how your energy is used, how you produce heat, and how you consume oxygen.

Thyroid cancer develops when cells change or mutate. The abnormal cells begin multiplying in your thyroid and once there are enough of them, they form a tumor.

Types of Thyroid Cancer

Four types of thyroid cancer have been identified:

• Papillary thyroid cancer
• Follicular thyroid cancer
• Medullary cancer
• Anaplastic thyroid cancer

What are the symptoms?

If you have thyroid cancer, you probably can’t trace any signs of it in the early stages. Some of the symptoms of thyroid cancer are:

• Neck, throat pain
• Lump in your neck
• Difficulty swallowing
• Vocal changes, hoarseness
• Cough

Inherited genetic syndromes: Some conditions, including cancer, come from the DNA you get from your parents.

Iodine deficiency: If you don’t get much of this chemical element in your diet, you could be at more risk for certain types of thyroid cancer.

Radiation exposure: If your head or neck was exposed to radiation treatment as a child.

Is it treatable?

Thyroid cancer treatment is usually very treatable, even if you have more advanced stage of it. That’s effective treatments that give you a great chance for a full recovery. And surgery, when it’s needed, can sometimes cure it. At NU Hospitals, you will be well diagnosed under the supervision of some of the best thyroid surgeons with the right kind of thyroid cancer treatment.

Recovery Tips for Kidney Transplant Patients

After returning home, you want to resume ‘normal living’. If you feel like going for a movie, or any social occasion, DO IT! If you’d like to have friends visit you at home, that’s OK too! Try as much as possible to return to your normal routine.

However, the key is moderation and measuring your limits. Initially, you might have less energy but with time your body will heal and adjust to your new medications. There are also many things you should consider in your life after kidney transplant surgery that involve taking care of your new kidney.

Diet and exercise

If you were on dialysis before your transplant, you will notice a difference in what you can eat and drink once your new kidney has been transplanted. You will still need to eat foods low in salt and fat to prevent high blood pressure, and if you have diabetes, you need to watch your blood sugar. Exercise can help improve your heart and lung health, prevent weight gain, etc.

Anxiety, depression and mental health

Getting a kidney transplant isn’t a cakewalk, it’s normal to undergo all kinds of emotions afterward. If you’re experiencing feelings of anxiety, depression or guilt, please don’t consider yourself alone, many transplant patients experience these feelings at first, for many reasons.

• Mood changes may be a side effect of the immunosuppressant medicines you are taking.
• You may also feel stressed or anxious about your new lifestyle.
• Your family members may also have emotional changes as they also have to adjust to your new lifestyle.

Returning to work

If you are planning on going back to work, your transplant team may advise you to wait three to six weeks after your surgery. You will also be given certain limits on what you should do.

Keeping your new kidney healthy

To keep yourself healthy, and to make sure your new kidney works well, follow the below points:

• Take your immunosuppressant and other medicines exactly how your doctor will advise you.
• Know the signs of infection and contact your kidney transplant doctor immediately.
• Avoid being around people who are sick.
• Drink plenty of water to keep yourself hydrated.
• Consume foods that are low in salt, fat and cholesterol.

Consult at NU Hospitals because it offers one of the best kidney transplant surgeries in Bangalore.

7 Early Warning Signs of Kidney Disease

While the only way to know if you have kidney disease is to get tested, but here are 7 possible signs that prove that you may have kidney disease. If you’re at risk for kidney disease due to high blood pressure, diabetes, a family history of kidney failure or if you’re older than age 60, it’s important to get kidney treatment at regular intervals. Be sure to mention any symptoms of kidney failure to your doctor.

• You’re more tired, have less energy or are having trouble concentrating

A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. This can cause people to feel tired and weak. Another complication of kidney disease is anemia, which can cause weakness and fatigue.

• You’re having trouble sleeping

When the kidneys aren’t filtering properly, toxins stay in the blood rather than leaving the body through the urine. This can cause difficulty in sleeping. There is also a link between obesity and chronic kidney disease. So it’s important to keep a check of your weight.

• You have dry and itchy skin

Healthy kidneys do many important jobs. They help in removing wastes and extra fluid from your body. Dry and itchy skin can be a sign of the mineral and bone disease that often accompanies advanced kidney disease, when the kidneys are no longer able to keep the right balance of minerals and nutrients in your blood.

• You feel the need to urinate more often

If you feel the need to urinate more often, especially at night, this can be a sign of kidney disease. When the kidney filters are damaged, it can cause an increase in the urge to urinate.

• You spot blood in your urine

Healthy kidneys typically keep the blood cells in the body when filtering wastes from the blood to create urine, but when the kidney’s filters have been damaged, these blood cells can start to leak out into the urine.

• Your ankles and feet are swollen

Decreased kidney function can lead to sodium retention, causing swelling in your feet and ankles.

• You have a poor appetite

This can be a general symptom but a buildup of toxins resulting from reduced kidney function can be one of the causes.

Equipped with some of the finest kidney specialists and world-class amenities, NU Hospitals has positioned itself as one of the best kidney hospitals in India.