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Diabetic Renal Disease Essay

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Updated: Apr 16th, 2019

Introduction

Diabetic renal disease also known as diabetic nephropathy is a medical condition which affects an individual’s blood sugar level as well as the kidney. This condition is characterized by persistence in albuminuria, reduced glomerular filtration rate and the increase in blood pressure within the arteries.

Research findings have shown that kidney disease is a complication that is associated with diabetes. Diabetic nephropathy has been a major course of kidney complications in those infected and a significant course of mortality. The disease is usually diagnosed after urinalysis and screening of the patient in relation to diabetes (Mogensen 2006, pp.640).

The albumiburia level is usually measured so as to determine whether the patient is affected by this condition. Early treatment is therefore very vital in preventing or delaying the onset of this condition. It particularly affects those patients who are affected by diabetes mellitus.

The high blood sugar levels in the patient usually result in the incapacitation of the kidney hence hindering the normal functioning of this organ. It becomes difficult for the kidney to filter blood hence resulting in full blown diabetes.

Under normal condition, the capillaries in the kidney are not damaged and hence act as filters to the unwanted substances in the blood. When these capillaries are damaged due to diabetes, these substances are not filtered and hence the impurities are retained in the blood (Lewis 2009).

The increase in blood glucose forces the kidney to filter much blood. When this condition persists over time the system collapses and blood proteins are passed to the urine a condition known as microalbuminuria. When this worsens, the condition is known as macroalbuminuria and this is characterized by huge amounts of proteins being found in the urine (Bennett 2005, p. 338-342).

The patient diagnosed with this complication is characterized by a number of signs and symptoms which include the dilation of the renal artery. The patient is likely to have fluid build-up, insomnia, general body weakness, loss of appetite, difficulty in concentration as well as stomach upsets.

When a laboratory test is carried out, such a patient is likely to have proteins in his/her blood. This is due to the damage caused on the capillaries in the kidney as evident in the specimen.

The system that helps in filtering the blood is damaged hence the blood proteins pass through the damaged capillaries into the urine. The patient is also likely to have an enlarged kidney as evident in the specimen. The risk of hypertension is quite high in this particular patient (Makita 2010, p. 963-975).

The patient with this condition is prone to cardiovascular diseases due to the damages caused on the blood vessels. This can be seen in the provided specimen as the blood vessels on the kidney appear to be swollen. Kidney failure is quite evident in the patient diagnosed with this condition.

The patient is also likely to pass urine that is full of foam. This is due to the high protein as well as glucose levels in the urine. The patient is also likely to have blurred vision.

This is caused by the damages on the blood vessels. Those blood vessels at the back of the eye or the retina are not spared. Once they are damaged, they start bleeding and hence cause the patient to have a blurred vision and in severe cases blindness might occur.

The patient is also likely to experience the narrowing of the arteries that lead to the kidney and have skin ulcers that take too long to heal. The patient is prone to peripheral nerve dysfunctions. The hypertension is basically due to the narrowing of the artilleries. There is poor circulation of blood in the blood vessels hence causing high blood pressure and hypertension (Brenner 2012, p. 4777).

The skin ulcers that take too long to heal are caused by the damage that occurs on the blood vessels. It therefore becomes difficult for the white blood cells to be transported to these areas. The concentration of antibodies in these areas is very low hence the difficulty in the healing of these ulcers.

Kidneys of a person affected by diabetes nephropathy retain excessive water and salts in the blood. This in the end results in increased blood pressure and hypertension. The excessive fluids are trapped within the body organs hence causing facial and leg swelling. The blood vessels in the specimen appear to be swollen which is primarily caused by the retention of excessive fluids by these vessels (Levey 2004, p.40-51).

The kidney in this specimen appears to be severely damaged hence its inability to perform the normal function of filtering impurities from the blood. The patient is therefore likely to have form in his/her urine due to the inability of the kidney to retain blood proteins and glucose within the blood.

The same is therefore passed to the urine. Hypertension is also caused by the fact that precipitated proteins are deposited in the blood vessels. The patient is also prone to conditions such as anemia, bone diseases and acidosis. In a normal person, the kidney is able to process the proteins in the blood unlike the diabetic person whose proteins cannot be synthesized hence are released into the urine.

The microvascular inflation is quite evident in diabetic patients as evident in the specimen provided. Most of the blood vessels are inflated due to the precipitation of protein particles on the membranes of these vessels (Watkins 2006, p. 293).

This particular patient is also prone to edema. This is a condition characterized by the swelling of the legs. The major cause of this is the retention of the interstitial fluid. The fluid is secreted into the interstitium and it is not easily drained away hence causing the legs to swell.

Edema is also caused by the biochemical and structural changes that are witnessed in the blood capillaries in the kidney as evident in the specimen shown. The vessels are made more permeable hence making it easier for the fluid to go through and be retained in the body tissues hence causing edema.

The tissues and blood vessels in the specimen appear to be swollen. This is due to the retention of excess water within these tissues hence causing the swelling (Hasslacher 2005, pp.234).

This patient suffering from the diabetic nephropathy is also likely to be witness an increase in weight. This is caused by the continued retention of fluid blood into the system hence causing the body to gain more weight (Ritz 2009, p. 302).

There are several remedies aimed at the prevention or slowing down of the diabetic kidney disease. One of the ways for the prevention of this condition is the intake of drugs that reduce the blood pressure. These drugs are aimed at protecting the kidney glomeruli and lower protenuria hence protein molecules are not passed to the urine. The most widely used drug is the lipsinopril (Selby 2009, p. 33).

Angiotensin Receptor Blockers are also used with the intension of ensuring the normal functioning of the kidney and lowering the wearing down of capillaries within the kidney hence slowing down the effects of the diabetic renal disease. Antihypertensive medicine is therefore very important in such a case.

It is also recommended that patients with this condition consume foods that are low in protein levels so as to prevent the onset of the kidney failure. Glycemic control is also quite crucial in the prevention or slowing down of this condition.

Patients with this condition are prone to high sugar or glucose levels hence the need to control the same. Insulin is quite important in the conversion of this glucose to energy and when the body does not respond to the insulin produced the same accumulates in the blood vessels hence causing hypertension (Whelton 2012, pp. 113).

Monitoring and controlling of blood sugar levels is very important in the prevention of this condition. In some cases, it might be necessary to administer insulin after meals or after intensive body activity so as to ensure that the ingested food is converted to glucose and broken down to produce the energy required by the body so as to avoid the build-up of glucose in the blood stream.

In cases where the disease has become full blown, dialysis and kidney transplant is the best remedy. Dialysis is quite vital in cleaning impurities out of ones blood in cases where the kidneys have failed. The blood is usually pumped out of the body and passed through a special filter that removes the impurities and it is then returned to the blood stream (Bakris 2012, p. 919).

The patients with diabetic renal disease need to keep their glucose levels at less than 7 percent and this can only be achieved through continuous check-ups. Insulin injection, issuing of the appropriate medication and proper diet are quite crucial in this case.

Physical Exercise is also important in such patients so as to facilitate the conversion of ingested food to glucose which is broken down for the provision of energy to the body. Appropriate measures should be taken to maintain low blood pressure of not more than 130/80. It is also important to measure the efficiency of the kidney by determining the protein levels in the urine.

For such patients, it is important to ensure that the average blood glucose is maintained at 155 mg%. Diabetic nephropathy patients who have been well taken care of should have lower cholesterol levels in their blood and reduced blood pressure which also reduces the risk of hypertension (Bojestig 2008, pp. 259).

The Metabolic Syndrome and obesity is mostly associated with the failure of the kidney to respond to insulin. The condition prevents the normal functioning of insulin particularly in the conversion of food into glucose and further breakdown of the same for the production of the energy for the body. The condition t leads to an increase in the glucose levels in the blood.

The blood vessels are blocked hence leading to high blood pressure. The most affected are the people who do not exercise, those who take in food rich in glucose/sugar and those on a high-protein diet.

These conditions are quite conducive for one to become diabetic hence the need for people to check their diets and lifestyle. An increase in people with the metabolic syndrome and obesity would imply an increase in people developing diabetic complications (Ziyadeh 2006, p.103).

Diabetic Nephropathy Kidney Specimen

Diabetic Nephropathy Kidney Specimen.

List of References

Bakris, G. 2012, ‘Calcium channel blockers versus other antihypertensive therapies on progression of NIDDM associated nephropathy,’ Kidney International , vol. 33 no. 1, pp. 919.

Bennett, P. 2005, ‘Prevention of diabetic renal disease with special reference to microalbuminuria,’ Med Pub , vol. 15 no. 5, pp. 338-342.

Bojestig, M. 2008, ‘Declining incidence of nephropathy in insulin-dependent diabetes mellitus,’ New England Journal of Medicine , vol. 44 no. 5, pp. 359.

Boner, G. 2003. Management of Diabetic Nephropathy. New York: Taylor & Francis.

Brenner, B. 2012, ‘Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy,’ Hypertension and Chronic Kidney Disease Progression, vol. 20 no. 2, pp. 4777.

Hasslacher, C. 2005. Diabetes and the Kidney. London: John Wiley & Sons.

Levey, A. 2004, ‘The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease,’ American Journal of Transplantation, vol. 38 no. 8, pp. 40-51.

Lewis, J. 2009, ‘The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy,’ Journal of Renal Care,’ vol. 33 no. 2,pp. 4-11.

Makita, Z. 2010, ‘Mechanism of endothelial dysfunction in chronic kidney disease,’ The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, vol. 9 no. 6, pp. 963-975.

Mogensen, C. 2006, ‘The stages in diabetic renal disease: With emphasis on the stage of incipient diabetic nephropathy,’ diabetic nephropathy , vol. 10 no. 4, pp. 640.

Ritz, E. 2009, ‘Diabetic nephropathy in type II diabetes.’ American Journal of Kidney Diseases , vol. 12 no. 5, pp. 303.

Selby, J. 2009, ‘The natural history and epidemiology of diabetic nephropathy,’ The Journal of American Medical Association , vol. 5 no. 3, pp. 47.

Watkins, P. 2006, ‘Progression of nephropathy in long-term diabetics with proteinuria and effect of initial anti-hypertensive treatment,’ Scandinavian Journal of Clinical & Laboratory Investigation , vol. 1, pp. 293.

Whelton, P. 2012, ‘Blood pressure and end-stage renal disease in men,’ International Journal of Cardiology , vol. 8 no. 2, pp. 1113.

Ziyadeh, N. 2006, ‘The extracellular matrix in diabetic nephropathy,’ American journal of kidney diseases , vol. 1, no 1.pp103.

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