Complications

KIDNEY DISEASE

Kidney disease, or nephropathy, is a condition in which diabetes overworks the kidneys over a period of years to the point of kidney failure. It is characterized by the presence of proteins in the urine.

How does it happen? The kidneys filter waste products from the blood and into the urine, and useful substances like proteins remain in the blood because they are too big to pass through the filters. High levels of sugar caused by diabetes can cause the kidneys to filter too much blood, which overworks and breaks down the filters. Over time, these filters in the kidneys begin to leak and protein is able to pass through into the urine in a condition called microalbuminuria. Eventually, the kidneys will lose all of their filtering ability. Wastes will build up in the blood, and the kidneys will fail. End-stage renal disease follows soon after, requiring either dialysis or a transplant.

What are symptoms? Symptoms do not usually appear until nearly all kidney function is lost. Even then, kidney disease does not have specific symptoms. However, the initial sign is fluid buildup. Other signs include: sleep loss, poor appetite, upset stomach, weakness, and difficulty concentrating. Protein in urine is also a good indicator.

What are treatments? It is important to keep control of blood sugar levels and blood pressure, through minor diet changes, weight loss, and exercise. Failing that, taking medication to lower blood pressure or switching to a low-protein diet is possible.

What happens if the kidneys fail? A transplant or dialysis, having the blood filtered by a machine, are the available options.

Kidney Replacement Therapy

When the kidneys fail, they must be replaced either by dialysis or a transplant.

What is dialysis? The more common of the two, it is a process of filtering the blood through a machine. There are two types: hemodialysis and periotneal dialysis.

What is hemodialysis? An artificial machine kidney outside of the body removes waste products from the blood. Hemodialysis must be performed two or three days a week, lasting for three to five hours a session. The machine works the same as a kidney, simply filtering waste from the blood and then returning the clean blood back to the body. Special considerations include: high or low blood pressure during treatment, upset stomach or muscle cramps, special diet to remain healthy, nerve problems, anemia, bone disease, poor nutrition, infection, complications with the access point (created during a surgery before treatment), and difficulty regulating insulin doses.

What is peritoneal dialysis? Rather than having a machine act as the kidney, the lining inside the abdomen becomes the filter. A tube is surgically inserted, and a cleansing fluid is put through the tube. Wastes then move into the fluid, which is drained from the body. There are two types: continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD). CAPD is performed by the patients themselves by attaching a bad with the fluid to the tube and raising it to shoulder level; the fluid runs into the abdomen, the bag is unhooked, and in several hours the fluid can be drained and replaced by new fluid. CCPD is performed, usually during sleep, by a machine, which pumps the fluid into the abdomen and drains it.

How about kidney transplants? Though transplants offer the best chances of survival end-stage renal disease, it is difficult to secure a kidney match. First, there is a shortage in organ donors. Second, organ matching means that when the recipients on the waiting list are narrowed down to who best matches the donor kidney, the organ goes to whoever waited longest. It may be years before an organ is donated, and dialysis must be used in the interim. Rejection, when the body attack the donated organ as a foreign body, is also a risk. Recipients must use immunosuppressant drugs for the rest of their lives, creating a future susceptibility to infection and diseases. In addition, the transplant does not cure diabetes, and if nephropathy develops again, the new kidney will also eventually fail.

DIABETIC KETOACIDOSIS
DKA stands for diabetic ketoacidosis, a serious condition that can result in diabetic coma (passing out for a long time) or even death.

KETONES are acids in the blood that are produced when your cells don’t get enough glucose for energy and your body begins to burn fat instead. Ketones present in urine is a sign that your body is not getting the amount of insulin that it needs; this is can be a warning sign that you’re diabetes is out of control.
High ketone levels can poison the body!!!

Causes
1. Lack of insulin
2. Lack of nourishment (food)
3. Low blood glucose / Insulin Reaction