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VOLUME 7 NUMBER 1 • MARCH 2010
35
SA JOURNAL OF DIABETES & VASCULAR DISEASE
Patient
information
leaflet
HOW TO PROTECT YOUR KIDNEYS
FROM DIABETIC KIDNEY DISEASE
Diabetes mellitus is associated with an array of complications. Since
there has been an increase in the prevalence of diabetes mellitus, dia-
betic nephropathy has also become more common.
WHAT IS DIABETIC NEPHROPATHY?
It is the type of kidney disease seen in poorly controlled diabetic patients.
It usually presents with swelling of the feet and body and is associated
with an increase in blood pressure.
WHAT ARE THE RISK FACTORS FOR DIABETIC NEPHROPATHY?
the presence of other diabetic complications
•
poorly controlled glucose
•
poorly controlled blood pressure
•
being overweight
•
smoking
•
positive family history of renal disease
•
ethnicity
•
HOW IS THIS CONDITION DIAGNOSED?
In patients with type 1 diabetes mellitus, urine testing should begin five
years after diagnosis. In type 2 diabetes patients, it should begin at diag-
nosis. Urine testing should then be done annually and specific attention
should be paid to the degree of proteinuria. The presence of albumin
suggests diabetic nephropathy.
S Afr J Diabetes Vasc Dis 2010;
7
: 35
HOW DO I PROTECT MY KIDNEYS?
Blood pressure control:
The presence of high blood pressure acceler-
ates the development of other complications. Both systolic and diastolic
hypertension has an effect on the development and rate of progression of
this disease. It is recommended that blood pressure should be kept below
130/80 mmHg, and in patients with renal disease we should aim to have
it below 125/75 mmHg. Limiting your salt intake, quitting smoking and
taking regular exercise could also help attain blood pressure goals.
Glucose control:
Several studies have shown that more intense glucose
control reduces the risk of developing diabetic nephropathy. The goal is
set at a fasting glucose level of less than 6.0 mmol/l. The HbA
1c
, which is
a laboratory test that gives an average of your glucose control over the
past 10 to 12 weeks, should be less than 6.5%.
Lifestyle changes:
Limit your salt intake. We should aim to have a total
salt intake of less than 6 g per day.
Minimise your total dietary fat intake daily. A fasting lipogram should
be done at least annually. The goals set regarding this include having a
total serum cholesterol level below 4.5 mmol/l and a triglyceride level
below 1.7 mmol/l.
Smoking should be discouraged by all means. Stop immediately, this
is obligatory!
Start with a regular exercise programme, even if it is only 30 minutes
per day. Aim for a body mass index of less than 25 kg/m
²
or, in the case
of obese patients, aim for a 10% reduction in weight.
In association with Pharma Dynamics in the interests of protecting your kidneys.
R Flooks
Renal Unit, Pelonomi Hospital,
Bloemfontein
