What is diabetes? Diabetes is a chronic disease that occurs as a result of the body’s difficulty in properly using carbohydrates, which results in an increase in blood glucose. The cause is the lack of insulin production in the pancreas or failure in its use. Types of Diabetes: Type 1.- When the pancreas of the person suffering from it does not produce the insulin that is needed. Type 2.- When the insulin produced by the pancreas of the sick person is not effective and does not function. Type 1 Diabetes is more common in children and young adults although it can occur at any age. People with Diabetes 1 need to administer insulin to control blood glucose levels. Diabetes 1 represents 5-10% of the entire population with Diabetes. Type 2 Diabetes is more common in older people, particularly those who are overweight. Currently, as a result of a sedentary lifestyle and the increase in obesity of the population, it also occurs in younger people. Often, Diabetes 2 can be controlled with diet, weight loss and exercise and also with pills. Diabetes 2 represents 90-95% of the entire population with Diabetes. What complications can Diabetes give? When glucose circulates in the blood instead of being used as energy, its concentration increases, hyperglycemia. This entails short and medium-term complications that, if not prevented, can affect the majority of blood vessels in our body. The most significant long-term complications are at the level of small vessels such as those of the kidney (nephropathy) and retina (retinopathy) and large vessels, causing the so-called generalized vascular disease, which affects the heart, brain, and lower extremities. It also affects nerve conduction leading to the so-called diabetic neuropathy, explains nephrologist in Delhi. What symptoms guide us to the presence of Diabetes? The onset of Type 1 Diabetes is often sudden and may include symptoms such as increased urinary frequency, abnormal thirst, extreme tiredness, irritability, weight loss, frequent infections. Diabetes 2 starts gradually and is generally not detected. Sometimes symptoms similar to those of type 1 diabetes may appear, but much more attenuated. Often the initial symptoms are not detected and the diagnosis of the disease is made late, years after the onset of the disease. At that time in half of the patients, complications are already present. Who is at risk for diabetes? Some people may be more predisposed to present the disease. The most relevant factors are:
Which is the treatment? Diet, exercise, drugs called oral antidiabetics and finally insulin. Can you prevent the onset of diabetes or its complications? Overweight and sedentary life are modifiable factors that can clearly influence the onset of Diabetes in predisposed people. Therefore, there are two clear factors that can be prevented. Why does the kidney get sick? It is quite frequent? What can be done to prevent kidney disease? Kidney disease caused by diabetes occurs in a third of the population with diabetes. The first specific fact that alterations in the kidney are occurring is the presence of a protein called albumin in small amounts in the urine. This alerts you to the possibility that the small blood vessels that feed the kidneys may suffer damage if we do not act. There are interventions and drugs that can prevent and reverse kidney damage in the early stages, the best nephrologist in Delhi says. Diabetic kidney disease “Diabetic nephropathy”: Kidney disease caused by Diabetes is called Diabetic Nephropathy. It is a chronic and progressive disease that develops in a third of people with diabetes, says kidney specialist in Delhi. High blood glucose levels affect the small vessels throughout the body and also those that are part of the kidneys. When these small vessels or capillaries are damaged, they do not work properly affecting their function, filtration. Toxic products can then accumulate in the blood, while other necessary substances such as proteins are eliminated in the urine improperly. If this progresses, we can reach the complete loss of kidney function that stops its filtration process, warns the best kidney specialist in Delhi. Risk factors for kidney disease in Diabetes:
Signs and symptoms of kidney disease in Diabetes: Symptoms of kidney involvement may appear late, when the organ is already severely damaged. It is important to know the early signs that can alert us to the onset of kidney damage:
Without treatment, diabetes can cause serious long-term complications: Nephropathy. Diabetes is the leading cause of kidney failure in the developed world and accounts for approximately 35-40% of new cases of kidney failure each year, says top nephrologist in Delhi. Retinopathy. Diabetes is the leading cause of blindness and visual impairment in adults in developed countries. The incidence of blindness is 25 times higher in people with diabetes, compared to the general population. Neuropathy. Nerve injuries, along with peripheral vascular disease make diabetes the most common cause of amputation not resulting from an accident or trauma. People with diabetes are 15 to 40 times more likely to need an amputation of the lower limbs compared to the general population. Cardiovascular diseases. People with diabetes are 2 to 4 times more likely to develop cardiovascular disease than people without diabetes – people with type 2 diabetes have the same risk of having a myocardial infarction as people without diabetes who have already suffered a first heart attack. The risk of mortality from cardiovascular disease is 40 times higher than in people without diabetes. The development of the initial phases of diabetic nephropathy is frequent. Throughout life, about 50% of people with type 1 diabetes develop microalbuminuria – the presence of albumin protein in the urine, which is an indicator of impaired renal function. Approximately 20% of people with type 1 diabetes develop renal insufficiency In Caucasian people with type 2 diabetes, between 5 and 10% develop chronic end-stage renal insufficiency (IRCT), while among those not Caucasians the proportion is even higher. Diabetic renal failure is the most common cause of admission to a renal replacement, dialysis in Delhi or kidney transplant in Delhi, in most countries of the world. In India, about one third of people with end-stage chronic renal failure suffer from diabetes. It is estimated that this population will grow at an annual rate of 8%. Up to 40% of new cases of IRCT can be attributed to diabetes. The risk of IRCT is 12 times higher in people with type 1 diabetes compared to those with type 2 diabetes. There are two treatment options when the kidneys fail: Dialysis (peritoneal dialysis or hemodialysis) and kidney transplant. The costs of both treatments are high. It is estimated that diabetes represents between 5 and 10% of the national health budget in developed western countries. Diabetic renal failure develops so slowly that it may not show symptoms for many years. The best way to detect the problem is the analysis of urine for proteins, which normally should not be present, such as albumin. It is recommended that every person with diabetes undergo a urinalysis every year for albuminuria, suggests top kidney specialist in Delhi. There is conclusive evidence that good blood glucose levels can significantly reduce the risk of developing complications and slowing their progression in all types of diabetes. The control of high blood pressure and high levels of blood fats (hyperlipidemia) is also very important.
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What is pyelonephritis? Urinary tract infection is any infectious condition that affects one or more parts of the urinary tract, formed by the kidneys, ureters, bladder, and urethra. Low urinary infections are those that affect the bladder and/or urethra. High urinary infections occur when there is involvement of at least one of the kidneys.
Pyelonephritis is a bacterial infection of one or both kidneys. Kidney infection is a potentially serious case, since we are talking about the infection of a vital organ. It is a picture that can have severity similar to pneumonia. If not treated on time and correctly, pyelonephritis can lead to sepsis and multiple organ failure. Fortunately, the vast majority of cases respond well to the arsenal of commercially available antibiotics. The cases that evolve in a negative way are those that take to receive the treatment or when the patient is already too weakened by other diseases, warns nephrologist in Delhi. Pyelonephritis is a frequent cause of scar formation in the kidneys and can lead to a partial loss of renal function, especially in patients who have recurrent infections. Causes According to the best nephrologist in Delhi, kidney infection occurs in two ways. The main route is the ascending one, when the bladder bacteria reach the ureters and can go up to the kidneys. This typically occurs in untreated or improperly treated cystitis. Less frequently, asymptomatic colonization of the bladder by bacteria can also be the source of a kidney infection. In these cases, the patient has bacteria in his bladder, but shows no symptoms, because the germs are only colonizing it, without attacking it. Therefore, not all people report symptoms of cystitis before the arrival of pyelonephritis, explains kidney specialist in Delhi. The second mode of infection of the kidneys is by blood, when a bacterium that is causing an infection somewhere in the body travels through the bloodstream and lodges in the kidney. This route is much less frequent than the ascending route. In addition to cystitis, which is the main risk factor, there are other situations that may increase the risk of kidney infection. We can cite the use of bladder catheters, urological surgeries, renal calculus, anatomical abnormalities of the urinary tract and diseases of the prostate that cause obstruction of urine flow. Patients with a weak immune system, such as diabetics, renal failure, cirrhosis, carriers of the HIV virus or patients taking immunosuppressive medications, have a higher risk of developing cystitis that evolves for pyelonephritis, says nephrologist in Gurgaon. Symptom Typical symptoms of pyelonephritis are fever, low back pain, nausea, vomiting, and general condition. There may also be symptoms of cystitis, such as painful urination and desire to go to the bathroom frequently, even when the bladder is empty. Another common sign is the presence of blood in the urine (hematuria), which normally occurs as a Coca-Cola colored urine, explains kidney specialist in Gurgaon. Pyelonephritis is divided clinically into 3 categories:
Complications As already mentioned, if pyelonephritis is not treated properly with antibiotics, there is a high risk of progression for severe sepsis. Bacteria present in the kidney can easily reach the bloodstream, spreading throughout the body and causing multiorgan failure, warns nephrologist in Noida. Another problem of pyelonephritis, especially if recurrent, is permanent kidney damage. Patients with chronic pyelonephritis may develop with end-stage renal failure and need hemodialysis in Delhi. Diagnosis The diagnosis of renal infection is usually made only with clinical symptoms. Laboratory tests help confirm the diagnosis. The blood count typically has an elevated white blood cell count and the CRP is elevated. In urine tests, pus (leukocytes in the urine) and blood (red blood cells in urine) are common. The urine culture should always be requested since it is able to identify the bacterium causing pyelonephritis, helping in the choice of appropriate antibiotics. However, since the urine culture takes at least 48 hours to stay early, we should not wait for its result to start antibiotic treatment. After leaving the results, the kidney specialist in Noida decides to keep the initial antibiotic or changes to a more effective one. Treatment In general, pyelonephritis treatment is performed in the hospital with intravenous antibiotics. If the patient is in good health and is still in good condition, he can receive the first dose intravenously and then complete the rest of the home treatment with oral antibiotics. In most cases, however, the patient is well disabled and two or three days of hospitalization end up being necessary to control the infection. In patients with chronic pyelonephritis, urologist evaluation is necessary. Often, the patient must undergo surgery in order to correct the anatomical abnormalities of the urinary system that are perpetuating a kidney infection. According to the top nephrologist in Delhi, Pyelonephritis is not a contagious disease, so there is no risk of contamination of relatives or close people. Pyelonephritis should always be treated with antibiotics. Medications called “natural” can provide temporary relief, but only postpone the proper treatment of the infection, causing risks for the patient. Establishing an adequate diet in the patient suffering from chronic renal failure is essential to achieve a correct nutritional status and consequently favor its rehabilitation. Many of these patients are undergoing dialysis in Delhi. Diet therapy in peritoneal dialysis The peritoneal dialysis is a technique that allows extrarenal blood purification through the peritoneum (the serous membrane that covers the inside surface of the belly and forms several folds that wrap or support the abdominal viscera). It consists of the installation of a small tube in the abdomen through which a prepared liquid is introduced that must be allowed to act for a certain time (4-5 hours). This liquid is responsible for absorbing toxic waste substances and excess water. After the time this waste liquid is allowed to leave the body, explains nephrologist in Delhi. Nutritional advice
Diet therapy in hemodialysis patients The hemodialysis (or artificial kidney) is a dialysis technique consisting of extrarenal blood purification by hemodialyzers. The patient’s blood passes through a special filter by contacting a dialysis fluid that circulates through the same filter. Direct contact allows the release of toxic and waste substances and excess water into the dialysis fluid. The diet of a patient undergoing hemodialysis should be supervised by a kidney specialist in Delhi. It is important to remember that despite the many restrictions, variety is allowed in the diet. Foods advised against
Milk and its derivatives are controversial foods in hemodialysis patients. On the one hand, caution must be taken because of its phosphorus contribution, which in patients with renal insufficiency cannot be eliminated by the kidney. But on the other, they are an important source of calcium, an essential mineral in bone composition. For these reasons, this food group must be very controlled. Generally, drug therapy is used to control the metabolism of these two minerals, explains kidney specialist in Noida. Anemia is one of the most frequent symptoms associated with chronic renal failure. Patients with anemia have a higher risk of mortality and cardiovascular complications, as well as a reduction in their quality of life and an increase in the number of hospitalizations. So, the treatment of anemia in patients with chronic renal failure is a priority objective of their therapy Chronic renal failure (CRF) is an irreversible disease that is characterized by kidney injury and impaired function, which progresses over time. CRI is classified into five phases, which are defined by the level of renal function, which is measured through the estimated glomerular filtration rate (TFGe). The lower the GFR, the more severe the IRC, explains the best nephrologist in Delhi. There are several factors that contribute to the progression of CRI. The four most common causes of CRF are diabetes, hypertension, glomerulonephritis or inflammation of the kidney’s filtering units, and polycystic kidney disease, an inherited disease. The aging of the population together with the increasing number of patients with type 2 diabetes associated with obesity has led to an increase in the number of people with CRF or at high risk of suffering from it, which is estimated to affect 10% of our population, says kidney specialist in Delhi. Over time, the CRI generally progresses to a stage in which patients have renal function so impaired that they could not live without the help of dialysis or kidney transplant in Delhi. Without these treatments, the IRC would lead to the death of the patients. According to the best kidney specialist in Delhi, the initial stages of CRF are difficult to diagnose, since the symptoms are not very apparent until the disease has progressed significantly. With this progression the symptoms appear: nausea, vomiting, bad breath and itchy skin, because of the toxic metabolites that would normally be filtered and eliminated from the blood through the kidneys, but that in the presence of CRF accumulate to levels harmful. Anemia One of the most frequent symptoms of CRF is anemia, which appears when the kidneys, because of their impaired function, stop producing enough erythropoietin, the hormone that stimulates the production of red blood cells that carry oxygen to the whole organism. Anemia in these patients is a serious disease, but it is little diagnosed and treated little. In the presence of anemia, the number of red blood cells in the blood is decreased, below their normal values, says top nephrologist in Delhi. Red blood cells contain hemoglobin, a red, iron-rich protein that carries oxygen from the lungs to other organic tissues. Oxygen helps provide the energy the body needs for all its normal activities. In the presence of anemia, hemoglobin levels are also low, lower than normal levels. According to top kidney specialist in Delhi, when there is anemia, the body gets less oxygen, so it has less energy than is necessary to function properly. The main symptoms of anemia are fatigue, weakness, respiratory distress, difficulty in concentration or confusion, dizziness or fainting, pale skin, tachycardia and a constant feeling of cold. Recent data suggest that in elderly patients, anemia is also associated with deterioration of mental functions, decreased exercise capacity, reduced quality of life and development of left ventricular hypertrophy. Without treatment, severe anemia is also associated with more frequent hospitalizations and increased treatment costs, doctor for kidney in Delhi says. Anemia develops early on IRC and some studies suggest that most patients already have anemia the first time they consult with the nephrologist in Delhi. Studies also suggest that one in three patients in our country has low hemoglobin values. Patients with CKD anemia have a higher risk of complications and mortality from cardiovascular diseases than the general population. Recent data suggest that the majority of patients with CRF die before they undergo dialysis in Delhi. Anemia treatment Erythropoiesis stimulating agents play an important role in the treatment of IRC anemia, since they stimulate the production of red blood cells. The treatment with these agents is recent, dating back to the 1980s, with the isolation of the human erythropoietin (EPO) gene, followed by the introduction of the first innovative agent, epoetin alfa, in 1989. Subsequently, darbepoetin alfa, a novel recombinant erythropoietic protein, has been introduced. Darbepoetin alfa has a different structure that gives it greater biological activity, that is, it allows the protein to stay longer in the blood. This is important because it allows reducing the frequency of administration, from two or three times a week to once or twice a month, which is done by injection. This provides greater comfort for patients. Nephrologist in Gurgaon says that the treatment of anemia in CRF allows the correction of hemoglobin levels and the number of red blood cells, which reduces mortality, reduces complications and the number of hospitalizations, and improves the quality of life from the patients. Introduction Chronic renal failure, also known as chronic kidney disease, is a silent and fairly common disease, despite receiving very little publicity and being unknown to the majority of the population. In this article, the best nephrologist in Delhi explains what are the measures that effectively help prevent chronic kidney disease. We are not going to talk about miraculous diets, natural remedies, alternative treatments or any other type of measure that is not based on serious scientific studies. Epidemiology of chronic kidney disease Some statistics help us understand the importance of chronic kidney disease:
Therefore, although unknown to the population, chronic renal failure is so common that about 1/3 of the population is at risk. What are the main causes of chronic kidney disease? Dozens of diseases can cause kidney damage, but approximately eight of them are responsible for most cases in adults, namely:
In addition to the diseases mentioned above, there are several other risk factors for chronic kidney disease, such as obesity, smoking, cardiovascular disease, high cholesterol, prostate hyperplasia, advanced age, family history of kidney disease, etc. Among these all factors, advanced age, diabetes and high blood pressure are the factors that are most associated with chronic kidney disease, says nephrologist in Delhi. How to prevent kidney disease? According to the nephrologist in Noida, there is no magic or miraculous recipe for the prevention of kidney diseases. There is no food, plant, herb or isolated therapy that helps prevent a person from developing kidney disease. The prevention of kidney disease necessarily involves the control of risk factors. There are risk factors that can be avoided, such as the consumption of nephrotoxic drugs, others that can be controlled, such as high blood pressure, and there are also those that have nothing to do, such as old age and family history. No one can stop aging and their genetic load cannot be changed. Let’s talk about some of the main risk factors for chronic kidney disease that can be prevented or at least controlled: Control blood pressure Having blood pressure persistently above 140/90 mmHg is one of the most important risk factors for kidney injury. The higher the pressure, the greater the risk. In addition to treatment with medications, hypertension can also be controlled by a low salt diet, physical exercises, body weight control and moderation in the consumption of alcoholic beverages. Avoiding cigarettes is also important, suggests nephrologist in Gurgaon. Control blood glucose levels Diabetes is the leading cause of chronic renal failure in the world. The more uncontrolled the diabetes is and the more years of illness the patient has, the greater the risk of kidney injury. Diabetes cannot be cured, but it can be controlled. Currently, it is recommended that patients with diabetes should try to keep glycosylated hemoglobin below 7%. Avoid medications that are harmful to the kidneys Some very popular medications can be nephrotoxic drugs, that is, toxic to the kidneys. The most common are anti-inflammatory. The consumption of any anti-inflammatory so frequently and for prolonged periods can cause kidney damage. Other drugs that can cause kidney damage are the antibiotic gentamicin, lithium, aspirin (doses higher than 500 mg) and cyclosporine. Control uric acid values Very high levels of uric acid, mainly above 10 mg / dL, are associated with an increased risk of kidney injury, especially if the patient has gout. Therefore, the control of uric acid, either through medication or with a low purine diet, is an important step, explains kidney specialist in Delhi. Avoid cigarette Individuals who smoke have an increased risk of developing chronic renal failure. keep a healthy weight Obesity is also associated with an increased risk of chronic kidney disease. All individuals with a BMI greater than 30 kg / m² should seek to lose weight. Do the prostate exam In men over 60 years, prostate hyperplasia can be a cause of kidney disease, so an evaluation of urologists is important. Do blood and urine tests Since chronic renal failure is a silent disease, it is important to detect it early. The urinalysis and determination of blood creatinine are the only ways to detect kidney disease in asymptomatic stages. We explain these two exams in details in the following articles: Consult a nephrologist If you have a strong family history of kidney disease, visit the nephrologist in Noida so you can do a checkup, in order to identify the first signs of kidney problems. If you have repeated urinary tract infection or frequent kidney stones, follow-up with the nephrologist in Gurgaon is also indicated. Situations in which there is no prevention According to the kidney specialist in Gurgaon, it is not always possible to prevent kidney injury, no matter how healthy you are. Kidney disease often has a strong genetic component that cannot be eliminated. This is the case, for example, of polycystic kidney disease. If you inherit from a parent the mutant gene that causes cysts in the kidneys, there is nothing that can be done. Another situation that is not usually preventable are cases of glomerulonephritis. This group of diseases of the glomeruli frequently originates from immune system problems that we still don’t understand very well. As much as you lead a healthy lifestyle, you can develop a glomerular disease with no apparent cause. Many times patients with glomerulonephritis are young and previously healthy, says doctor for kidney in Delhi. |
AuthorA passion for helping others led me down the path of Medicine into a career that allows me to provide my patients with high quality healthcare. As a professional Nephrologist in Delhi since 2008, I bring a holistic approach to medicine in order to find comfortable and effective solutions for everyone. Read on to learn more about my medical background. Archives
March 2023
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