When a diabetic patient has raised blood glucose (sugar) levels, it causes certain chemicals in the kidneys to also rise. Consequently, this causes the glomeruli (filtering mechanism) in your kidney(s), to leak. Albumin, a necessary requirement for your body to stay healthy, leaks into the urine. The high blood sugar levels can also cause the protein present in the glomeruli to bond together. The linking of the proteins triggers a process known as ‘scarring’, which is also called glomerulosclerosis.
With time, as the scarring tissue increases, it progressively replaces the healthy kidney tissue causing the kidneys to become dysfunctional. The kidneys become less able to filter the toxic wastes and extra fluids from the blood and gradually fail, resulting in an end-stage-kidney failure.
The first indication that you have developed diabetic kidney disease is when the albumin that has leaked into your urine is between 30 to 300mg / day. If left untreated, the microalbuminuria could develop into proteinuria. Proteinuria is the stage, where the albumin leak into the urine is beyond 300mg and is irreversible. It is also an indication the kidney has reached the end-stage and that it is failing.
Swelling in parts of the body like your hands, feet, ankles or face and the large amount of protein leak in your urine are the first symptoms to look for.
Listen to video talk by Dr. R Balasubramaniyam MBBS, DNB (Gen.Med), DNB (Neph) about the same topic here: https://www.youtube.com/watch?v=tyxY6iXGsvg
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