Once such a patient is confirmed to have Diabetic Kidney Disease, the respective medical team starts the patient on specific medicines for intensive blood glucose control & maintenance.Such patients need to be thoroughly explained the importance of taking their medicines regularly to avoid sudden abnormal spikes in blood glucose levels which could otherwise propagate further kidney damage rapidly.
During the course of blood glucose-lowering treatments, the medical team may also perform imaging scans such as an Ultrasonography of the patient’s kidneys to assess the extent of kidney damage that has been already done. This, along with separate blood work for kidney function can help the doctor understand the stage of chronic kidney diseasethat the patient is currently at. This serves as a guide for planning the patient’s further treatment.
Similarly, blood work can help doctors broadly identify whether the cause for damage to kidney filters (& the resulting Proteinuria) has stemmed from a defect in your immune system.
In such cases, doctors may further order an ultrasound scan to understand the extent & pattern (patchy or uniform) of kidney damage. When this category of patients presents early enough, such that they are clinically stable and still have greater than 40% of kidney function remaining, doctors may want to order a Kidney Biopsy.
This is a test where doctors draw-out a tiny portion of the patient’s kidney tissue with a special syringe under local anaesthesia. A pathologist studies this kidney tissue specimen under a microscope to precisely confirm the immune system defect that has brought about kidney damage.
Such measures help differentiate kidney damage in Lupus (Lupus nephritis) from IgA nephropathy or FSGS. Each of these is immune system-mediated kidney damage but has a separate combination of medicines when diagnosed early on.
Identifying the root cause & initiating appropriate disease-specific treatment aims to contain the “assault” to kidney filters by the respective disease process. Blood glucose-lowering drugs for Diabetics, Medicines dampening the Immune System for patients with Immune-mediated kidney damage falls under this category. This helps to prevent the rapid & progressive increase in protein loss in urine over time.
Along with the root cause, patients with Sustained Proteinuria are also started on other medicines that are common for all CKD patients with Proteinuria irrespective of the root cause. These may include:-
Blood Pressure lowering medication for specific Kidney Disease
Whatever be the method, when patients have a high BP, blood gushes with great force towards the delicate kidney filters and literally shoves & pushes through them. This badly damages the intricate filtration layers in the kidneyand causes Plasma Protein to leak out in urine. Hence BP lowering meds have a crucial role to play in helping contain the extent of Plasma Protein Loss in Urine per day.
Commonly used BP-lowering medicines in CKD belong to either of the following classes:
Apart from Medicines, doctors would refer the patient to a Renal Dietitian. Such professionals undergo special training to guide on specific nutritional requirements and their safe limits of consumption with CKD.
Reducing overall Sodium intake — a mineral commonly found in table salt helps to control Blood Pressure. Maintaining healthy blood pressure levels helps reduce proteinuria as explained in the above section. Read more here.
In addition to all the above measures, your medical team will advise you on a host of lifestyle modifications. These are primarily targeted at reducing your overall blood pressure and thereby, restricting Protein loss in Urine for the longest possible time.
The earlier the doctors trace Proteinuria, the earlier they can advise their patients to adopt the above measures.This ensures that the rate of progression of kidney damage will markedly slow down and the patient will be able to keep the inevitable kidney failure at bay for a longer time period.
We use the term “inevitable” here because that is how Chronic Kidney Disease (CKD) works. Kidney Failure is, unfortunately, an unavoidable consequence of CKD. All available treatments only aim to dampen the symptoms or attenuate and halt disease progression. They CANNOT reverse/cure kidney failure from CKD.
Therefore, we at ATK re-iterate the importance of being vigilant about your health (Urine health in particular) to arrive at a potential diagnosis in good time.
Now, it may be tempting to avoid medical tests lest you should test positive for a disease condition that’s damaging your kidneys. And we understand where this kind of psychology stems from, in patients.
But to be honest, delaying a diagnosis harms you physically, psychologically and financially a lot more, when compared with patients who started receiving treatments early on.
So what are you waiting for? Pledge to be truly vigilant about your health today.
Stay Well, all of you!
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