Prevention and Delay of Renal Disease Progression
Author: Ham Pato
Drugs for blood pressure
Scientists have made tremendous progress in developing methods that slow the onset and progress of kidney disease in diabetics. Drugs that lower blood (antihypertensives) can significantly delay the development of kidney disease. A class of drugs, inhibitors of angiotensin converting (ACE) inhibitors, have proved effective in preventing progression to stages IV and V.1 diuretics, beta blockers, modulators of the nervous system and adrenergic blockers calcium channels may also help control blood pressure in patients with diabetes mellitus.
An example of an ACE inhibitor captopril is effective, usually made by doctors to treat kidney disease in diabetic patients. The benefits of captopril extend beyond its ability to lower blood pressure: can directly protect the glomeruli. ACE inhibitors decreased proteinuria and slowed deterioration even in diabetic patients who had no hypertension.
Any medicine that helps patients to achieve the goal of having a voltage of less than 125/75 is beneficial. Patients with mild hypertension or persistent microalbuminuria should consult their doctors about the use of antihypertensives.
Diets low in protein.
A diet containing reduced amounts of protein can benefit people with kidney disease related to diabetes. In diabetes, excessive consumption of protein can be harmful. Experts recommend that most patients with kidney disease stage III or IV consume limited amounts of protein
Intensive control of blood glucose
Antihypertensive medications and low-protein diets can slow kidney disease when significant nephropathy exists, as in stages III and IV. A third treatment, known as intensive monitoring of blood glucose or glycemic control, has shown promise in people with type 1 and type 2, especially those in nascent stages of renal disease.
The intensive control is a treatment aimed at maintaining blood glucose close to normal. Treatment often involves determining the concentration of blood glucose, administering insulin frequently throughout the day depending on food consumption and exercise, stick to a diet and exercise plan, and frequently consulting a team of professionals health. Some people use an insulin pump to administer the medication throughout the day.
Several studies have emphasized the beneficial effects of intensive treatment. Two of them, funded by the National Institute of Diabetes and Digestive and Kidney (National Institute of Diabetes and Digestive and Kidney Diseases, NIDDK), part of the National Institutes of Health (National Institutes of Health), are the Study of Control and Complications of Diabetes (Diabetes Control and Complications Trial, DCCT) 2 and a study conducted by researchers at the School of Medicine, University of Minnesota.3 A third study, conducted in the United Kingdom, is Prospective Study of Diabetes in the United Kingdom (UK Prospective Diabetes Study, UKPDS) .4
In the DCCT, which was conducted from 1983 to 1993, involving 1.441 people with type 1 diabetes. The researchers found a 50 percent decrease in both the onset and evolution of renal disease (stages I and II) in participants who underwent intensive treatment to control blood glucose. These patients had an average blood glucose concentration of 150 milligrams per deciliter, about 80 milligrams per deciliter than concentrations observed in patients receiving traditional treatments.
In the study of Minnesota School of Medicine, researchers examined renal tissue from people who had had diabetes for a long time and who had received kidney transplantation. After 5 years, patients who received intensive treatment had a significantly lower glomerular lesions than those who did not. This result, combined with the findings of the DCCT and studies conducted in Scandinavia, suggests that any program that gets a steady decline in glucose concentrations in the blood will be beneficial for patients in the incipient stages of diabetic nephropathy.