HEALTH MATTERS: Monitoring kidney function is very important for diabetics

Of the estimated 24 million people diagnosed with dia betes, nearly 180,000 are living with kidney failure.

By Aparna Sahoo, D.O. Princeton HealthCare System
    As the number of Americans diagnosed with diabetes continues to rise, so does the number of people experiencing complications from the disease.
    In fact, diabetes is the leading cause of chronic kidney disease and kidney failure in the United States, accounting for nearly 44 percent of new cases, according to federal statistics. Of the estimated 24 million people diagnosed with diabetes, nearly 180,000 are living with kidney failure as a result of the disease.
    Clearly, not everyone who has diabetes will develop kidney disease, but patients need to be mindful of the risk and take measures to detect the early stages of kidney disease and do what they can to slow the progression.
    Your kidneys are made of up millions of tiny blood vessels that filter waste products from the bloodstream. These waste products are then removed in the urine, and useful substances, such as protein and red blood cells, which are too big to pass through the filters, remain in the blood.
    Diabetes, however, damages these small blood vessels in the kidneys by increasing pressure inside the vessels and causing structural changes within the kidney. In the initial stage of diabetic kidney disease, the filtering function of the kidney is higher than normal; subsequently, more and more amounts of protein leak into the urine.
    As the disease progresses, the kidneys continue to deteriorate and begin to shut down completely, resulting in the accumulation of waste products in the blood.
    Early-stage kidney disease has no outward symptoms, making it especially important for people with diabetes to have regular blood and urine screenings. These screenings enable doctors to measure kidney function and detect small amounts of protein called albumin in the urine, a sign that the filtering system is breaking down.
    The American Diabetes Association and the National Institutes of Health recommend screenings annually for people with diabetes.
    Symptoms of late-stage kidney disease include fluid build-up, loss of sleep, poor appetite, persistent nausea and vomiting, weakness and difficulty concentrating.
    Patients with diabetes, however, can slow the progression of kidney disease by maintaining control of their glucose levels as well as their blood pressure.
    Research indicates that even a slight rise in blood pressure can make kidney disease worse. Moreover, high blood pressure is not only a cause of kidney disease, but can occur as a result of the disease. There are no symptoms of high blood pressure until pressures are dangerously high, making it critically important to get regular screenings for high blood pressure by a health professional.
    Patients can help lower their blood pressure through diet and exercise. In many cases, medication is also necessary. ACE inhibitor or angiotensin receptor-blocking drugs are often prescribed for patients with diabetes and high blood pressure and kidney disease.
    Early stages of kidney disease may occur within 5 to 10 years of having diabetes. However, 15 to 20 years may pass before overt kidney failure occurs, according to the National Institutes of Health. For patients who develop kidney failure, there are two treatment options — dialysis and kidney transplantation.
    The best course of action against kidney disease, however, is to prevent it or at least slow its progression through early detection and controlling your glucose levels and blood pressure.
Princeton HealthCare System, through its Community Education & Outreach Program, will host a discussion “Diabetes, High Blood Pressure & Kidney Disease: What You Need to Know!” from 7 p.m. to 8:30 p.m. on Wednesday, Jan. 28, at the Community Education & Outreach building at 731 Alexander Road, Suite 103, in Princeton. To register for the free session or for more information visit www.princetonhcs.org/calendar or call 888-897-8979.
Dr. Aparna Sahoo is a board certified nephrologist and member of the medical staff of Princeton HealthCare System
To find a physician with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
‘Living with Celiac Disease’
to feature expert nutritionist
    The Princeton Area Celiac Association invites the public to attend a lecture on “Living with Celiac Disease — physically, psychologically and fiscally,” on Wednesday, Feb. 18, at 7 p.m., in the Nassau Club at 6 Mercer St., Princeton.
    Anne Roland Lee, MSEd, RD, LD, director of Nutritional Services for Schar USA, based in Santa Fe, N.M., will be the featured speaker.
    The event is free and open to the public, but can accommodate only 60 people. Registered attendees will have first preference for seats.
    Before joining Schar USA as the director of Nutritional Services, Dr. Lee was the nutritionist at the Celiac Disease Center at Columbia University, where she was involved in patient care and research while pursuing a doctoral degree. Her research resulted in published articles on the effect of a gluten-free diet on the quality of life and the economic impact of a gluten-free diet.
    Dr. Lee has written a chapter in a nutrition text and co-authored a chapter in a gastroenterology text on celiac disease. She has developed numerous educational materials on the gluten- free diet for both patients and professionals. She is a member of the ADA Evidence Analysis Library project on celiac disease and has been a reviewer for the On Line Nutrition Care Manual.
    To register or to obtain more information about the newly formed Princeton Area Celiac Association, write to [email protected].