Treatment for Diabetic Kidney Disease

A) Controlling blood pressure helps to protect kidneys. BP must be maintained at:

• Systolic blood pressure -120–130 mm Hg
• Diastolic blood pressure-70–80 mm Hg

B) Medications such as Angiotensin-converting enzyme (ACE) inhibitors are administered to patients as these are more effective than other blood pressure medications in protecting kidney function. Patients who are not tolerant of ACE can be given Angiotensin II receptor blockers (ARPs).

Both these medications can cause hyperkalemia, a condition in which there are higher than normal levels of potassium in the blood.

C) Some life style changes are also required when treating diabetic nephropathy. The changes include a low-protein, low-fat, low-salt diet and regular exercising. Also avoid smoking or using tobacco products.

D) Controlling cholesterol through medications is also mandatory.

E) Renal Replacement Therapy (RRT) - Once the patients progress to end-stage renal disease, RRT may be carried out in the following ways:

• Hemodialysis in which the toxic products are removed from blood through filtration
• Peritoneal dialysis which involves filtration of wastes through the lining membrane of the abdominal cavity
• Kidney transplant in those with complete kidney failure