Preventing Diabetic Kidney Disease: A Comprehensive Guide for Indians Living with Diabetes
What is Diabetic Kidney Disease?
Why is DKD a Concern?
Rising Diabetes Rates:
With about 77 million people living with diabetes in India, DKD is becoming increasingly common.
Asymptomatic Nature:
Many individuals do not show symptoms until significant kidney damage has occurred, making early detection crucial.
Economic Burden:
The cost of treatment for CKD can be overwhelming, with an estimated 170,000 to 250,000 new patients needing renal replacement therapy each year.
Consequences of Neglecting DKD
1. Health Complications: Progression to CKD or ESRD significantly increases the risk of cardiovascular diseases and other complications.
2. Quality of Life: Patients may experience fatigue, weakness, and decreased ability to perform daily activities.
3. Financial Strain: The average annual cost for patients with ESRD can exceed ₹213,144 (approximately $3,181), while dialysis alone costs around ₹12,000 per month. For patients at stage 4 CKD, annual treatment costs can reach approximately $33,162. This financial burden can lead families into debt and limit access to necessary healthcare services.
1. Regular Screening:
Urine Microalbuminuria Test: Conduct annually. A result >30 mg/g indicates early kidney damage.
2. Blood Sugar Control:
Aim for an HbA1c level <7%. Utilize medications and lifestyle changes to maintain optimal glucose levels.
3. Blood Pressure Management:
Target <130/80 mmHg. Use ACE inhibitors or ARBs if protein in urine is present.
4. Dietary Modifications:
Follow a low-sodium, low-protein diet rich in fruits, vegetables, and whole grains. Limit processed foods and sugars to manage weight and blood sugar levels.
5. Physical Activity:
Engage in at least 150 minutes of moderate exercise per week (e.g., brisk walking, cycling).
6. Weight Management:
Achieve and maintain a healthy BMI (18.5-24.9). Aim for a weight loss of 5-10% if overweight.
7. Avoid Smoking and Limit Alcohol:
Quit smoking and limit alcohol intake to reduce overall health risks.
8. Regular Health Check-ups:
Schedule annual kidney function tests (serum creatinine and eGFR) alongside diabetes management appointments.
Importance of Early Detection
The urine microalbuminuria test is essential for early detection since DKD often progresses without symptoms. Early intervention can significantly slow the progression to CKD or ESRD.
Conclusion
Preventing diabetic kidney disease requires proactive measures tailored to individual health needs. By focusing on regular screening, blood sugar control, dietary modifications, and lifestyle changes, individuals with diabetes in India can significantly reduce their risk of developing this serious complication. The consequences of neglecting DKD are dire—not only in terms of health but also financially—making awareness and prevention paramount for improving outcomes in this population.
Citations:
[1] https://www.degruyter.com/document/doi/10.2478/dine-2023-0003/html?lang=en
[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC10387965/
[3] https://www.degruyter.com/document/doi/10.2478/dine-2023-0003/pdf
[4] https://diabetesjournals.org/care/article/47/1/26/153797/Economic-Costs-of- Diabetes-in-the-U-S-in-2022
[5] https://pmc.ncbi.nlm.nih.gov/articles/PMC5297507/
[6] https://academic.oup.com/ckj/article/15/1/60/6352495
[7] https://pmc.ncbi.nlm.nih.gov/articles/PMC9206440/
[8] https://dghs.gov.in/WriteReadData/userfiles/file/NPCDCS/Fin%20-%20CKD% 20guidelines.pdf