Can diabeties affect the kidneys?
Yes, certainly it can and the condition is called as a diabetic nephropathy.
How common is a diabetic nephropathy?
Usually 30 to 50 % of insulin dependant diabetics will have DN and 10 to 15 % of patients of NIDDM will have diabetic nephropathy.
How long after getting diabetes is the kidney affected?
The incidence of kidney being involved is more clearly known for IDDM( juvenile diabetics). Usually require 14–15 years before the kidney is involved. In those who do not have juvenile diabetes the duration is variable.
What are factors that predict the high development of diabetic nephropathy?
Following are predict a higher risk
- Sugar control is poor.
- If the blood pressure is not controlled.
- In a patient whose family history of high blood pressure or heart disease.
- Those who have brothers or sisters with diabetic nephropathy.
What are the precautionary measures that should be taken to prevent diabetic nephropathy?
It is very important for all diabetics to have their kidney function checked by their doctors and early reference to the nephrologist is also important. The following factors do help in progression of kidney disease.
- Good control of Blood pressure
- Good control of the blood sugar level.
What happens if the kidney functions keeps deteriorating in spite of treatment?
In many diabetics despite treatment they will go on to end stage of renal disease i.e. they will require dialysis or transplant.
Can diabetics undergo renal transplant?
Yes, diabetics can undergo renal transplant in fact combined kidney and pancreas transplantation is carried out in IDDM patients.
Are the results of renal transplants poorer in diabetics?
To some extent that is true as they may have more infections and tend to have ischemic heart problems.
How many patients will eventually go on to require dialysis among diabetics?
In NIDDM about 10 to 15 % eventually will require dialysis. It may be as high as 30% in those who are IDDM patients.
Are any special problems encountered in diabetic patients who are on dialysis?
It is generally more difficult to place fistulas or grafts in diabetics. In addition they are more prone to infections.
Can a member of the family donate kidney to a diabetic patient?
Should not be used for patients with adult onset diabetes (NIDDM). Since siblings and children have increased risk of development of diabetes. In IDDM patients the sibling should be at least 10 years older than the age of onset of diabetes of the recipient.