Causes, Risk factors and Stages for Diabetic Kidney Disease
Some of the diabetic nephropathy risk factors include:
- Uncontrolled blood sugars
- High blood pressure
- High cholesterol
- Smoking
- Genetic predisposition-Some people have genetic predisposition to develop DKD
- Ethnicity – Native or African Americans and Hispanics are more prone to develop nephropathy
- Age-The risk of DKD increases with age
Stages-Diabetic kidney disease (DKD) progresses through several stages, each marked by increasing kidney damage
- Stage 1 - Normal kidney function (very early stage of diabetes) - Above-normal glomerular filtration rate (GFR) indicates very early stage of diabetes.
- Stage 2 - Developing Diabetes/ Stage of Microalbuminuria - The GFR remains elevated or may be normal, but above-normal levels of the protein albumin (micro-albuminuria) in the urine is indicative of glomerular damage. Patients may excrete more than 30 mg of albumin in the urine over a 24-hour period.
- Stage 3 - Overt Diabetes/ Stage of Macroalbuminuria) - A 24-hour period evaluation shows that the urine contains more than 300 mg of albumin in it. This is indicative of glomerular damage that has progressed to clinical albuminuria. Hypertension is also commonly seen in patients with stage 3 nephropathy.
- Stage 4 - Moderate chronic kidney disease - Glomerular damage continues, the kidneys lose their filtering abilities and more amount of protein albumin accumulates in the urine. Blood urea nitrogen (BUN) and creatinine (Cr) levels increase. Hypertension is common at stage 4.
- Stage 5 - End-stage renal disease (ESRD) - GFR falls to approximately 10 milliliters per minute. Renal replacement therapy, including hemodialysis, peritoneal dialysis and kidney transplantation, is required for patients in this stage of the disease.
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It's important to note that DKD can progress rapidly in some individuals. Regular monitoring of kidney function and albuminuria is crucial for early detection and intervention.Once they reach the end stage disease the only option is to give them a renal replacement therapy in the form of dialysis or consider the patient for kidney transplantation.
