This week’s topic is diabetic nephropathy or kidney disease. 40% of people with diabetes have some form of nephropathy. Kidney disease is common among people with African, Hispanic or Native American backgrounds. Nephropathy occurs in five stages. The first stage your kidneys increase in size. The second stage microalbuminurea occurs. The third stage may cause your blood pressure to rise. The fourth stage increases the amount of protein passed through your urine. The final stage is kidney failure or end stage renal disease (ESRD). People with type II diabetes account for 50% of end stage renal disease. The sad reality is most nephropathy can be prevented with good blood glucose control. If you are at risk for diabetic nephropathy here are some important recommendations:

• You should have a microalbuminuria , creatinine and glomerular filtration rate lab drawn yearly. This is will tell you how well your kidneys are working.

• If the above labs reveal any kidney disease you need to limit your protein intake to less than 0.8g/kg per day.

• If you are taking Metformin, Glipizide or Glyburide, you may need to ask your doctor to consider discontinuing these medications.

• The average length of time for diabetic nephropathy to progress to kidney failure is 23 years.

• If you end up with end stage renal disease (ESRD), your treatment options are hemodialysis, peritoneal dialysis or a kidney transplant.

• Once you are on dialysis, you will need to limit your protein, potassium, sodium and phosphorus intake.

If you have any questions regarding kidney disease, please email me at askard@stablebloodsugar.com. Allison