Urinary Tract and Kidney Problems in Diabetes Part 2
and kidney problems are extremely common in both cases of type 1 and type 2 diabetes. Diabetic nephropathy is a common complication. This means that your kidney loses its ability to function the way it should. The first laboratory sign on a urinalysis is proteinuria, (protein in the urine). Another medical term for this condition is also known as Kimmelstiel-Wilson disease, or diabetic glomerulosclerosis.
As I had mentioned in a previous article link to this one, each of your kidneys is made up of hundreds of thousands of nephrons. The nephrons are a cluster of blood vessels called a glomerulus. The glomeruli is supposed to filter blood and then form your urine. The urine in turn, should drain down into the ureter.
When the glomerulus thickens, the kidney may begin to dysfunction by allowing more albumin which is protein to slip out. There is a simply test to detect this problem called a microalbuminuria test. If the level is over 30 after a 24 hour urine collection, this indicates a problem within the kidneys.
When diabetic nephropathy goes on progressing, the glomeruli are destroyed in increasing numbers. Thus, the levels of albumin increases.
Protein released into the urine may show up many years before you actually have other symptoms. Hypertension will often go with nephropathy. As more time passes, the kidney's abilities to work properly start declining, sometimes rapidly. Diabetic nephropathy can then get into chronic kidney failure until you have reached ESRD, which is End Stage Renal Disease. This happens usually within a 2-5 year time period after proteinuria.
Early stage diabetic nephropathy is known to be silent, and has no symptoms. Signs of this complication often don't appear until you have reached more acute renal failure. What you will probably notice then besides not feeling well, are:
fatigue-being too tired
foamy, or frothy urine
hiccups all the time
itchy skin all the time
nausea and vomiting in the acute stage
swelling of the legs and puffiness in the face
lack of any appetite
hypertension may be present
The goal once nephropathy is discovered is to slow it down along with other related complications. Once proteinuria is found, the blood pressure must also be kept in control by medications. Medicines such as angiotensin converting enzymes or angiotensin receptor blockers, are the medications of choice. These types of medications will reduce the diabetic nephropathy.
Over the counter drugs used to treat pain such as Ibuprofen, and Naproxen may injure the weakened kidneys. For alternatives on pain drugs, always ask your physician.
Urinary tract or bladder dysfunction can also be a contributing factor to kidney diseases. Diabetes can damage nerves that control the bladder muscles. Both men and women with diabetes often have urinary urgency, frequency, or leakage of urine. More severe symptoms include having a difficult time urinating and incomplete bladder emptying. These signs are indicative of what is known as neurogenic bladder. Your doctor should check out your nervous system, (this means the brain and the bladder nerves themselves). And your doctor may also run tests that include an IVP, (kidney test with dye), other xrays, and a general urological evaluation called urodynamics.
Treating a neurogenic bladder usually involves self catheterization when the biggest problem present is fluid retention in the bladder. And if urine leakage becomes too big a problem, then surgical procedures may help.
Urinary tract infections are also another problem for the diabetic. They occur when too much bacteria usually from the digestive system, enter the urinary tract. If bacteria are growing in the urethra, the infection is known as urethritis. The bacteria will sometimes go on up into the body and cause something more serious called pyelonephritis, a kidney infection. Signs of a urinary tract infection might be:
a frequent urge to urinate
pain or burning in the bladder/urethra during urination
bloody urine, (hematuria)
pressure above the pubic bone in women
feeling of fullness in the rectum for men
When the infection is present in the kidneys, you may be nauseated, and feel flank pain in your back. A fever will usually accompany kidney infections.
Treating the infection as soon as possible is vitally important. When these problems become too big, they can cause a shutdown of the whole urinary system, and kidneys may quit functioning as well.
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