Diabetic Kidney Disease (DKD), also known as diabetic nephropathy, is a serious complication affecting approximately 30 per cent of people with diabetes. This condition arises when high blood sugar levels damage the kidneys' filtering units, leading to progressive kidney dysfunction. Alarming statistics from the National Kidney Foundation reveal that DKD is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) globally.

The early stages of DKD often present without noticeable symptoms, making regular screening crucial for diabetes patients. But what causes diabetic kidney disease? We got in touch with Dr Debabrata Mukherjee, Senior Director of Nephrology and Renal Department, Max Hospital Gurugram who shares causes, symptoms and strategies to manage diabetic kidney disease.

Dr Debabrata Mukherjee shares that uncontrolled diabetes mellitus is the main cause of diabetic kidney damage. Renal blood vessel injury can occur when blood sugar levels are persistently high. Kidney dysfunction results from the kidneys' inability to filter waste materials and extra fluid from the blood over time as a result of this damage. Here are some other reasons that may raise the chance of getting diabetic kidney disease:

1) Diabetes Duration: The risk of developing diabetic kidney disease increases with the length of time a person has diabetes, particularly if blood sugar levels are not properly managed over time. This emphasizes the significance of early and continuous management.

2) Genetics: Due to related susceptibility factors, those with a family history of kidney disease are more likely to develop diabetic kidney disease (DKD), which is largely influenced by genetics.

3) High BP: Hypertension, or high blood pressure, raises the risk of diabetic kidney disease development by placing additional load on already damaged kidney function, which dramatically accelerates kidney damage in people with diabetes.

4) Poor Management Of Blood Glucose Level: The inability to consistently control blood glucose levels increases the risk of diabetic kidney disease by damaging blood vessels and the kidneys' sensitive filtering processes, which accelerates kidney dysfunction.

Dr Debabrata Mukherjee shares that early in the course of the disease, symptoms might not be obvious. As the illness worsens, symptoms may include:

1. Swelling: As a result of fluid retention, especially around the eyes, legs, and ankles.

2. Fatigue and Weakness: Caused by an increase of toxins in the body and anaemia.

3. Increased Urination: The kidneys' inability to filter fluids causes nocturia or nighttime urination.

4. Foamy Urine: Indicates the presence of excess albumin (protein) leaking into the urine.

5. Nausea and poor appetite: Caused by uremia, or the accumulation of waste in the blood

Dr Debabrata Mukherjee shares that in order to maintain kidney function and avoid complications, effective care of DKD involves a combination of medication and lifestyle modifications:

1) Blood Pressure Management: Medications such as ACE inhibitors or ARBs are used to specifically protect kidney function in blood pressure management for diabetic renal disease. Lowering blood pressure is another benefit of cutting back on sodium in food. Diabetes patients are less likely to experience the progression of kidney impairment when they regularly exercise and maintain a healthy weight.

2) Blood Sugar Control: To control blood sugar, eat a balanced diet rich in fruits, vegetables, lean meats, and whole grains. Follow prescription guidelines to reach and maintain ideal blood glucose levels, which are essential for successful diabetes management.

3) Changes In Lifestyle: Give up smoking and stay away from secondhand smoke; keep a healthy weight with regular exercise and a well-balanced diet; and drink alcohol in moderation to safeguard kidney function and general health.

4) Routine Check-Up: Diabetic kidney disease requires routine screening and monitoring to identify early signs of kidney disease. Urine albumin-to-creatinine ratio and estimated glomerular filtration rate tests are used to evaluate kidney function; controlling cholesterol lowers the risk of cardiovascular disease, which is important for managing the disease overall.