Here are ten tips that can make your kidney healthier and function better.
1. The aim of any diabetic treatment is to keep blood glucose levels near to normal. With regular self-monitoring, it is desired to keep blood glucose under control by having an HbA1C test. This test indicates one’s average blood glucose for the past 2 to 3 months. The target for most people with diabetes is to keep the level below 7 percent, if HbA1C test shows above 7.5 percent it indicates the need for a change in the treatment plan. Type 2 diabetes is a progressive disorder and calls for a change in the treatment plan periodically. Insulin is required if HbA1c is more than 9.5 percent at the time of diagnosis or more than 7.5 percent even after taking oral drugs. Poor glycemic control can result in numerous complications, including CKD. Studies such as the Diabetes Control and Complications Trial (DCCT), led by researchers at the University of Minnesota Medical School and the U.K. Prospective Diabetes Study (UKPDS) have suggested that any programme resulting in sustained lowering of blood glucose levels will be beneficial to patients in the early stages of diabetic nephropathy while preventing many other complications.
2. Regular urinalysis and measurement of protein (microalbuminuria) in urine has to be done at least once a year. Microalbuminuria is said to be present if urinary albumin excretion is ≥30 mg/24h. Given that there is day-today variability in albumin excretion, at least two of the three collections done in a 6-month period should show elevated levels before a person with diabetes is diagnosed as having microalbuminuria. Although, at this stage the kidney’s filtration function usually remains normal, a lot can be done to prevent the advanced stage of diabetes nephropathy. Creatinine blood test should be done at least once a year once the microalbuminurea indicates positive.
3. Many people with diabetes also have high blood pressure (HBP) which leads to the worsening of kidney, heart and eye diseases. A BP count lower than 130/80 will help keep your kidneys healthy. Get your BP checked at every visit and take medication as advised, if it shows on the higher side.
4. Control of lipids: LDL (bad) cholesterol should be less than 100 mg/dl, HDL (good) cholesterol should be above 50 mg/dl and triglycerides should be less than 150 mg/dl.
5. People who are at a risk of diabetic nephropathy, should also get themselves checked for the presence of coronary heart disease and retinopathy.
6. Follow doctors advice regarding medicines, insulin, meal planning, physical activity, and blood glucose monitoring. Your doctor can prescribe you drugs, such as ACE inhibitors or angiotensin receptor blockers (ARBs), as they are effective in protecting the kidney from BP related damage.
7. Inform the doctor about difficulty in passing urine, frequent need to urinate, burning or pain with urination, frothy or blood spotted urine or for that matter a strong odour in urine.
8. Check with your doctor before taking any medicine (especially pain killers) or any form of herbal medication.
9. Exercise regularly and stop smoking. One has to aim for at least 30 minutes of exercise most days of the week. Ask the doctor about activities that are best suited for you. If you suffer from any kind of discomfort while exercising, take rest immediately and visit your doctor.
10. Experts suggest diabetic patients should consume only the recommended dietary allowance for protein. If you already have kidney problems, your dietician may suggest you cut back on protein. This amounts to about 0.8 gms/kg body weight of protein intake/day.