Prevention before cure

So it was on the occasion of World Organ Donor Day (November 30) that several doctors tried to create awareness about diabetes and kidney ailments that can lead to complications. On the occasion,several hospitals held functions to mark the event and also felicitated people who have donated kidneys.

On the occasion,nephrologist Dr Abhay Sadre also pointed out that diabetes and kidney ailments can lead to complications. Diabetes is a condition where the body either does not produce enough insulin or does not respond properly to insulin – a hormone produced in the pancreas. When insulin is no longer produced or it is ineffective,glucose cannot enter the cells and keeps circulating with increased levels in the blood. This is where the problems begin.

The kidneys comprise millions of tiny filters or nephrons. In turn,the nephrons have even smaller vessels within them. The kidneys constantly remove wastes and toxins from the bloodstream. When glucose levels in the bloodstream are consistently too high,the nephrons (filters) are slowly destroyed.

The kidneys can no longer filter the blood,and wastes that would be excreted keep circulating in the bloodstream. Gradually,this gives rise to CKD.

Diabetics should undergo periodic or annual screenings to check kidney functions and detect kidney disease in time. Although CKD is not reversible,a treatment regimen and medical intervention is necessary so toxins do not build up within the body.

Along with strict glucose control,taking medications to control blood pressure and eating a low-protein diet to reduce stress on the damaged kidneys is called for. In severe cases of CKD,dialysis may be required to flush out toxins and clean the patient’s blood. Dialysis is a three or four-hour process that needs to be repeated every few days. There are two types of dialysis – haemodialysis and peritoneal dialysis.

In haemodialysis,a machine filters the patient’s blood thrice a week; the procedure takes three to four hours and must be done at a dialysis centre. Peritoneal dialysis — this can be performed independently at home. Here the blood is not filtered directly,but via the abdomen using fluids instead. Some patients find this more convenient.

“Kidney transplant is another option for those who can afford it,” says Dr Abhay Sadre. “There are risks involved though,due to other complications caused by diabetes. For instance,the urine of diabetics has high sugar content,which encourages growth of bacteria,leading to kidney infections. Diabetics must take special care and treat infections promptly. Kidney transplant also entails a long wait for a donor,” he adds.