How to Preserve the Life of Your Diabetic Kidneys

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By: Steve Edelman

Diabetes is one of the leading causes ofkidney failure, which soaks up a large partof the national health care dollar. However,kidney disease is preventable and treatableonce present.

Through years of clinical research, we’velearned of several techniques to prevent theonset and delay the progression of diabetickidney disease. In addition to aggressivelytreating kidney disease, screening methodsfor early diagnosis have been developed.

Prevention

The successful preventionof diabetic kidneydisease by maintainingtight control of bloodglucose has been provenconvincingly by theDiabetes Control andComplications Trial(DCCT).

In addition, people withhigh blood pressure maybe able to prevent theonset of diabetic kidneydisease by aggressivelytreating the bloodpressure to keep it in thenormal ranges or evenlower.

It is also be possible that angiotensinconverting enzyme (ACE) inhibitors, a typeof blood pressure medication, can preventthe onset of kidney disease if started earlyenough.

Early Detection

The first measure of diabetic kidney disease isthe presence of small amounts of albumin inthe urine, known as microalbuminuria.

Once microalbuminuria is present, there aretherapeutic ways to slow the progression ofdiabetic kidney disease. This is why screeningis so important—so that aggressivemanagement can be started in a timelyfashion.

If you have type 1 diabetes, you should bescreened for microalbuminuria once a yearbeginning five years from the time of yourdiagnosis.

Aggressive Management

Blood Glucose Control — Aggressive blood glucose control can slowthe progression of diabetic kidney disease.

Blood Pressure Control — Proper blood pressure screening is also animportant tool in detecting the signs of earlykidney disease. If you have or are at risk forthe development of kidney disease, I suggestyou obtain an accurate home blood pressuremonitoring device so that you can take yourown readings on a regular basis.

Use of ACE Inhibitors

ACE inhibitors have beenproven effective in preventingand slowing the progression ofdiabetic kidney disease in termsof reducing albumin spillage inthe urine and lowering bloodpressure.

Use of Angiotensin Receptor Blockers

If you are not able to take anACE inhibitor, there is another class ofmedications that work in a similar manneras the ACE inhibitors. They are calledangiotensin receptor blockers (ARBs), andthey may prove to be just as protective of thekidneys as the ACE inhibitors.

Remember

Through prevention, early detection andaggressive management, you can make adifference in the life of your diabetic kidneys.


Commonly Used ACE Inhibitors

  • Benzeptil
  • Captopril
  • Enalapril
  • Fosinopril
  • Lisinopril
  • Moexipril
  • Perindopril
  • Quinapril
  • Ramipril
  • Trandolapril

Commonly Used ARBs

  • Candesartan
  • Eprosartan
  • Irbesartan
  • Losartan
  • Telmisartan
  • Valsartan

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