Diabetes

PATIENTS & FAMILIES

DIABETES

Diabetes: un factor de riesgo importante para la enfermedad renal
La diabetes mellitus, generalmente llamada diabetes, es una enfermedad en la cual su cuerpo no produce suficiente insulina o no puede usar cantidades normales de insulina adecuadamente. La insulina es una hormona que regula la cantidad de azúcar en la sangre. Un nivel alto de azúcar en la sangre puede causar problemas en muchas partes de su cuerpo.

¿Hay diferentes tipos de diabetes?
Los más comunes son Tipo 1 y Tipo 2. La diabetes tipo 1 generalmente ocurre en niños. También se llama diabetes mellitus de aparición juvenil o diabetes mellitus insulinodependiente. En este tipo, su páncreas no produce suficiente insulina y debe inyectarse insulina por el resto de su vida. La diabetes tipo 2, que es más común, generalmente ocurre en personas mayores de 40 años y se llama diabetes mellitus de inicio en adultos. También se llama diabetes mellitus no insulinodependiente. En Tipo 2, su páncreas produce insulina, pero su cuerpo no la usa adecuadamente. El alto nivel de azúcar en la sangre a menudo puede controlarse siguiendo una dieta y / o tomando medicamentos, aunque algunos pacientes deben tomar insulina. La diabetes tipo 2 es particularmente frecuente entre los afroamericanos, los indios americanos, los latinoamericanos y los asiáticos americanos.

¿Qué le hace la diabetes a los riñones?
Con la diabetes, los vasos sanguíneos pequeños en el cuerpo se lesionan. Cuando los vasos sanguíneos en los riñones se lesionan, sus riñones no pueden limpiar su sangre adecuadamente. Su cuerpo retendrá más agua y sal de lo que debería, lo que puede ocasionar aumento de peso e inflamación del tobillo. Puede tener proteína en su orina. Además, los materiales de desecho se acumularán en su sangre. La diabetes también puede causar daño a los nervios en su cuerpo. Esto puede causar dificultad para vaciar la vejiga. La presión resultante de la vejiga llena puede hacer una copia de seguridad y dañar los riñones. Además, si la orina permanece en la vejiga por mucho tiempo, puede desarrollar una infección por el rápido crecimiento de bacterias en la orina que tiene un nivel alto de azúcar.

¿Cuántos pacientes diabéticos desarrollarán enfermedad renal?
Alrededor del 30 por ciento de los pacientes con diabetes Tipo 1 (aparición juvenil) y del 10 al 40 por ciento de los que tienen diabetes tipo 2 (aparición adulta) eventualmente sufrirán insuficiencia renal.

¿Cuáles son los primeros signos de enfermedad renal en pacientes con diabetes?
El primer signo de enfermedad renal diabética es una mayor excreción de albúmina en la orina. Esto está presente mucho antes de que las pruebas habituales realizadas en el consultorio de su médico muestren evidencia de enfermedad renal, por lo que es importante que se haga esta prueba anualmente. El aumento de peso y la inflamación del tobillo pueden ocurrir. Usarás el baño más por la noche. Su presión arterial puede ser demasiado alta. Como persona con diabetes, debe revisar su sangre, su orina y su presión arterial al menos una vez al año. Esto conducirá a un mejor control de su enfermedad y al tratamiento temprano de la presión arterial alta y la enfermedad renal. Mantener el control de su diabetes puede reducir su riesgo de desarrollar enfermedad renal severa.

What are the late signs of kidney disease in patients with diabetes?
As your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.

What does diabetes do to the kidneys?
With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood. Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.

How many diabetic patients will develop kidney disease?
About 30 percent of patients with Type 1 (juvenile onset) diabetes and 10 to 40 percent of those with Type 2 (adult onset) diabetes eventually will suffer from kidney failure.

What are the early signs of kidney disease in patients with diabetes?
The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in your doctor’s office show evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.

What are the late signs of kidney disease in patients with diabetes?
As your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.

What will happen if my kidneys have been damaged?
First, the doctor needs to find out if your diabetes has caused the injury. Other diseases can cause kidney damage. Your kidneys will work better and last longer if you:
Control your diabetes
Control high blood pressure
Get treatment for urinary tract infections
Correct any problems in your urinary system
Avoid any medicines that may damage the kidneys (especially over-the-counter pain medications)
If no other problems are found, your doctor will try to keep your kidneys working as long as possible. The use of high blood pressure medicines called angiotensin converting enzyme (ACE) inhibitors has been shown to help slow the loss of kidney function.

How are the kidneys kept working as long as possible?
The kidney doctor, called a nephrologist, will plan your treatment with you, your family and your dietitian. Two things to keep in mind for keeping your kidneys healthy are controlling high blood pressure in conjunction with an ACE inhibitor and following your renal diabetic diet. Restricting protein in your diet also might be helpful. You and your dietitian can plan your diet together. For Kidney and Diabetes friendly recipes click here to visit our Kidney Kitchen.

What is end stage renal failure in patients with diabetes?
End stage renal failure, or kidney failure, occurs when your kidneys are no longer able to support you in a reasonably healthy state, and dialysis or transplantation is needed. This happens when your kidneys function at only 10 to 15 percent.

How is kidney failure treated in diabetic patients?
Three types of treatment can be used once your kidneys have failed: kidney transplantation, hemodialysis, and peritoneal dialysis. To learn more about treatment options for kidney failure click here.

Can a patient with diabetes have a kidney transplant?
Yes. Once you get a new kidney, you may need a higher dose of insulin. Your appetite will improve so your new kidney will break down insulin better than your injured one. You will use steroids to keep your body from rejecting your new kidney. If your new kidney fails, dialysis treatment can be started while you wait for another kidney. To learn more about kidney transplant click here.

What about pancreas transplants?
Sometimes it is possible to perform a pancreas transplant along with a kidney transplant. Your doctor can advise you about this possibility.

What is the future outlook for patients with diabetes?
Today, more and more research dollars are spent on diabetes research. Hopefully, the prevention and cure of diabetes are in our future. In the meantime, you can manage your diabetes better with:

• Home monitoring of your blood glucose levels

• Maintaining an awareness of controlling your blood pressure, and possibly monitoring your pressure at home

• Following your individualized special diet.

DIABETES

SOURCE

© 2015 National Kidney Foundation. Todos los derechos reservados.

La información compartida está desarrollada únicamente por expertos internos en el tema, incluidas las juntas asesoras médicas, que han desarrollado pautas para el contenido de nuestros pacientes. Este material no constituye consejo médico. Se pretende unicamente con fines informativos. Nadie asociado con la National Kidney Foundation responderá preguntas médicas por correo electrónico. Por favor, consulte a un médico para recomendaciones específicas de tratamiento.