The Effect Of Ace Inhibitors On Kidney Function In Patients With Type 1 Diabetes
The Effect of ACE Inhibitors on Kidney Function in Patients with Type 1 Diabetes Article, Author, and Disclosure Information Author, Article, and Disclosure Information The summary below is from the full report titled Should All Patients with Type 1 Diabetes Mellitus and Microalbuminuria Receive Angiotensin-Converting Enzyme Inhibitors? A Meta-Analysis of Individual Patient Data. It is in the 6 March 2001 issue of Annals of Internal Medicine . The author is the ACE Inhibitors in Diabetic Nephropathy Trialist Group. Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine. Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.Continue reading >>
- Effect of eating vegetables before carbohydrates on glucose excursions in patients with type 2 diabetes
Great News: Trials Show Some Diabetes Drugs Can Actually Protect Your Kidneys
More people with diabetes are taking drugs like Jardiance and Farxiga, originally developed to lower glucose in people with type 2 diabetes, because the latest data confirms that these drugs can protect your kidneys. A therapy still under investigation, finerenone, has been developed to protect the kidneys of people with and without diabetes
Recent research is showing that certain drugs can benefit your kidneys if you have type 2 diabetes. Diabetes is the leading cause of chronic kidney disease , and many people don’t receive adequate treatment for this condition, so advancements in therapy to treat and prevent kidney disease are important for the 800 million people worldwide who live with chronic kidney disease. We bring you some of the newest findings on finerenone, Jardiance, and Farxiga – three medications that have been shown to protect the kidneys in people with decreased kidney function, including those with diabetes and CKD.
Finerenone is currently being tested to treat CKD in people with type 2 diabetes – it’s a new type of drug that interferes with the receptors that cause kidney cells to retain, or hold onto, excess salt and water. In the FIDELIO-DKD trial, almost 6,000 people with type 2 diabetes and kidney disease received either finerenone or placebo and were enrolled in the study for over two and a half years. The results from the trial demonstrated the benefits of finerenone:
Why is this important?
Newer Type 2 Diabetes Medications Have Heart And Kidney Disease Benefits Too
- Two newer classes of medications used to treat Type 2 diabetes have been shown to protect patients against heart disease and chronic kidney disease, in addition to their ability to help manage blood glucose.
- Patients with Type 2 diabetes have a high rate of chronic kidney and cardiovascular disease and more serious complications; these newer glucose-lowering medicines could help to reduce those risks.
- A multi-disciplinary approach to Type 2 diabetes care that includes primary care, diabetes, kidney and heart specialists could increase integrated care and provide more patients with access to these treatments, if appropriate, and achieve better outcomes.
Embargoed until 4 a.m. CT / 5 a.m. ET Monday, Sept. 28, 2020
The statement reviews evidence from multiple, large, international, randomized controlled trials of two classes of blood sugar control medications — sodium glucose co-transporter 2 inhibitors and glucagon like peptide-1 receptor agonists — in patients with Type 2 diabetes, chronic kidney disease and those who were either at risk for or already had cardiovascular disease. The composite results of the trials found that SGLT2 inhibitors and GLP-1 RAs can safely and significantly reduce the risk of cardiovascular events and death, reduce hospitalization and slow the progression of chronic to end-stage kidney disease including the risks of dialysis, transplantation or death.
Analysis of the clinical trials results yielded these recommendations:
How Can I Prevent Diabetic Kidney Disease Or Keep It From Getting Worse
To prevent diabetic kidney disease or keep it from getting worse, you can:
- Control your blood sugar
- Quit smoking or using tobacco
- Be active most days of the week
- Stay at a healthy weight
Diabetic kidney disease does not happen fast. Sometimes it takes many years. This means that you can take steps now to help protect your kidneys. Even if your kidneys are already damaged, you can control your diabetes to help keep them from getting worse.
Control your blood sugar
Keeping your blood sugar in a healthy range can help protect your kidneys. Healthy foods, being active, and certain medicines can help you keep a healthy blood sugar level. However, you will need to check your blood sugar often to know how you are doing.
When you have doctor’s appointments, you will probably have a blood test to check your hemoglobin A1C. This is a blood test that tells your doctor how your blood sugar levels have been over the last two or three months. Ask your doctor what your A1C number should be. Most people with diabetes should have an A1C less than 7%.
To check your blood sugar at home, you will use a blood glucose meter . You can get a meter at your local drug store, hospital, clinic or online. Your doctor can help you find a meter that is right for you and show you how to use it. Many insurance policies will help pay for your meter and other testing supplies.
In most cases, people with diabetes should aim for a blood sugar level:
Control your blood pressure
Control your cholesterol
Drug Reduces Risk Of Kidney Failure In People With Diabetes Study Finds
- Stanford Medicine
- A new landmark clinical trial shows that a drug lowers the risk of kidney failure by a third in people with Type 2 diabetes and kidney disease.
A new landmark clinical trial shows that a drug lowers the risk of kidney failure by a third in people with Type 2 diabetes and kidney disease.
“For the first time in 18 years, we have a therapy for patients with Type 2 diabetes and chronic kidney disease that decreases kidney failure,” said Kenneth Mahaffey, MD, professor of medicine at the Stanford University School of Medicine and co-principal investigator of the trial. “Now, patients with diabetes have a promising option to guard against one of the most severe risks of their condition.”
The trial involved 4,401 participants in 34 countries.
The drug, canagliflozin, improves on a nearly two-decades-old therapy that is currently the only treatment approved to protect kidney function in people with Type 2 diabetes. In the trial, canagliflozin also was found to reduce the risk of major cardiovascular events.
Canagliflozin increases the excretion of glucose through the kidneys. It has already been approved by the Food and Drug Administration to lower blood glucose in patients with Type 2 diabetes and to reduce the risk of major adverse cardiovascular events in patients with Type 2 diabetes and existing heart disease.
‘Definitive trial result’
‘Eagerly sought’ treatment
When Diagnosed Early Stopping Diabetic Kidney Disease May Be Possible
July 12, 2013
Dear Mayo Clinic:
My father was recently diagnosed with diabetic kidney disease. Is there a chance this can be reversed, or will he have it for life? What changes, if any, should he be making to his diet?
It is not uncommon for people who have diabetes to develop kidney problems. When diagnosed early, it may be possible to stop diabetic kidney disease and fix the damage. If the disease continues, however, the damage may not be reversible.
Diabetic kidney disease, also called diabetic nephropathy, happens when diabetes damages blood vessels and other cells in the kidneys. This makes it hard for them to work as they should. In the early stages, diabetic kidney disease has no symptoms. That’s why it is so important for people with diabetes to regularly have tests that check kidney function.
In later stages of the disease, as kidney damage gets worse, signs and symptoms do appear. They may include ankle swelling, test findings that show protein in the urine, and high blood pressure. Over time, diabetic kidney disease can lead to end-stage kidney disease.
If your father is in the early stages of diabetic kidney disease, there are several steps he can take to help protect his kidneys. First, it is critical to keep blood sugar as well controlled as possible. This not only helps the kidneys, but decreases the risk of other serious problems that can come from diabetes, such as blindness, heart attack and damage to the blood vessels and nerves.
What Is The Timing For Damage To The Kidneys If You Have Diabetes
Most people with type 1 diabetes develop changes in kidney function within three to five years of their diagnosis. About 30 to 40% of people with type 1 diabetes will develop more serious kidney disease, usually between 10 and 30 years after their diagnosis.
Less is known about how long it takes kidney disease to develop in type 2 diabetes. This is because type 2 diabetes can remain undiagnosed for some time, so even people who have recently been diagnosed may already have some form of kidney disease. However, it is believed that it follows a similar course to type 1 diabetes, but occurs at an older age.
What Increases My Chances Of Developing Diabetic Kidney Disease
Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your
- blood glucose is too high
- blood pressure is too high
African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.
You are also more likely to develop kidney disease if you have diabetes and
- have heart disease
- have a family history of kidney failure
Preventing Diabetic Kidney Disease: 10 Answers To Questions
Diabetic kidney disease is a decrease in kidney function that occurs in some people who have diabetes. It means that your kidneys are not doing their job as well as they once did to remove waste products and excess fluid from your body. These wastes can build up in your body and cause damage to other organs.
How To Help Prevent Kidney Disease When You Have Diabetes
The kidneys are vital organs responsible for waste management, which is crucial for maintaining your body’s chemical balance and blood pressure. If you don’t take good care of your kidneys, you’re risking a slew of health problems, some of which could cause these organs to shut down altogether. Some of the most common kidney-linked diseases are kidney stones, urinary tract infections, and hypertension.
How does diabetes affect the kidneys? Kidney disease and diabetes go hand in hand — in fact, diabetes is the leading cause of kidney disease, according to the National Institutes of Health . According to the Centers for Disease Control and Prevention , more than 25.8 million Americans have diabetes, and the high blood sugar levels that go along with diabetes require the kidneys to work harder to filter out excess water and wastes.
Diabetic nephropathy is a serious kidney-related complication of type 1 diabetes and type 2 diabetes. It is also called diabetic kidney disease. Did you know that about 10 to 40 percent of people with diabetes will develop chronic kidney disease ? Early on, kidney disease with diabetes has no known symptoms. According to the Mayo Clinic, in later stages of kidney disease, the signs and symptoms include:
- Appetite loss
- Protein in the urine
- Swelling of feet, ankles, hands or eyes
To protect the kidneys, follow these simple steps.
Is It Possible To Reverse Kidney Disease Once It Happens
It is believed that kidney disease cannot be reversed. Its progression can only be stopped or delayed through good blood sugar and blood pressure control, and medications. That’s why it is important to have your kidney function tested regularly. The earlier the diagnosis, the better able you and your healthcare team will be able to manage diabetic kidney disease.
Preventing Chronic Kidney Disease When You Have Diabetes
According to The Cleveland Clinic Foundation, diabetes is the cause of approximately 44% of all new cases of diabetic nephropathy. Nephropathy is a medical term for kidney disease. Diabetes can cause damage to the filters in your kidneys over time. As more damage occurs, chronic kidney disease can develop. CKD is a serious complication of diabetes. It cannot be cured, only managed. Getting an early diagnosis of nephropathy and treating your diabetes can help limit the kidney damage and may prevent kidney failure where dialysis becomes necessary.
An early diagnosis
An early diagnosis of diabetes can help your doctor treat the condition before it does more damage to your body. Type 1 diabetes is easily diagnosed in its early stages, before kidney damage occurs. However, Type 2 diabetes often goes undiagnosed for years. Many people who have Type 2 diabetes do not realize it.
Because Type 2 diabetes may have been present for many years before it is diagnosed, this means the high glucose content in the blood has had time to damage the tiny blood vessels in the kidneys. When these blood vessels are damaged, protein that is meant to remain in the body can leak into the urine. This is a condition called microalbuminuria, and it is an early symptom of kidney disease.
Control your blood glucose levels
Control your blood pressure levels
Keep healthy habits
Maintain Your Blood Glucose Levels In The Optimum Range
Your doctor will advise you to monitor your sugar levels after meals, exercising, and also how often you should track your blood glucose level to test whether your insulin is working. She will also advise you to get a regular A1C test. This is a blood test that shows your average blood glucose level over the past three months. The A1C is also one of the best tests to see if your blood sugar levels are controlled. A high A1C number shows that your blood glucose levels have been high during the past three months, which can be a problem for your kidneys.
Ask your healthcare practitioner what your A1C test score should be and maintain your blood sugar levels within range to protect your kidney health. Most type 2 diabetes patients are advised to keep their A1C below seven percent. Ask your doctor how much your score should be. Remember, reaching your A1C goal numbers will help you protect your kidneys.
Manage Diabetes High Blood Pressure And Heart Disease
If you have diabetes, high blood pressure, or heart disease, the best way to protect your kidneys from damage is to
Keep blood glucose numbers close to your goal. Checking your blood glucose, or blood sugar, level is an important way to manage your diabetes. Your health care team may want you to test your blood glucose one or more times a day.
Keep your blood pressure numbers close to your goal. The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Read more about high blood pressure.
Take all your medicines as prescribed. Talk with your health care provider about certain blood pressure medicines, called ACE inhibitors and ARBs, which may protect your kidneys. The names of these medicines end in –pril or –sartan.
Be careful about the daily use of over-the-counter pain medications. Regular use of nonsteroidal anti-inflammatory drugs , such as ibuprofen and naproxen, can damage your kidneys. Learn more about over-the-counter medicines and your kidneys.
To help prevent heart attacks and stroke, keep your cholesterol levels in the target range. There are two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels, which can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. A cholesterol test also may measure another type of blood fat called triglycerides.
Tips To Protect Your Kidneys And Keep Them Healthy
Every thirty minutes, your kidneys filter all of the blood in your body, removing toxins from the blood, excreting them in urine, and preventing damage to all of your organs. Your kidneys also regulate the alkaline/acid balance in your body, preventing you from becoming dangerously acidic.
Regulating acid and toxins is dangerous work. Your kidneys are vulnerable to toxic overload if you don’t protect them.
There are three types of serious kidney disease – acute renal failure, chronic kidney disease, and end stage renal disease.
Acute renal failure is when your kidneys abruptly stop working because of an injury or ingesting toxic substances. ARF may respond well to treatment, if the kidneys are not severely damaged.
When kidneys gradually lose the ability to function, it is typically due to chronic kidney disease or CKD, the most common type of kidney ailment. Often, there are no symptoms of CKD until the condition has advanced. Then patients may experience numbness or swelling in the hands and feet, frequent urination, nausea, anemia, and poor appetite.
Finally, end stage renal disease is a serious condition in which there is no or very little kidney function remaining, and the damage to the kidney is permanent. At this point, a patient is looking at daily dialysis sessions or a kidney transplant.
Ready for some good news? Kidney diseases are largely preventable. And there are ten steps you can take to keep your kidneys healthy and strong.
Tight Control Of Diabetes Can Protect Your Kidneys
March 6, 2017 – New York Nephrologist, Arthur Appel, MD, FACP, with Highland Medical, P.C., shares how managing diabetes protects your kidneys. Diabetes is the No. 1 cause of chronic kidney disease in the United States. But if you have diabetes you can protect your kidneys by keeping your blood sugar and blood pressure under control, according to Arthur Appel, MD.How Does Diabetes Harm the Kidneys?About one out of four adults with diabetes has kidney disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic kidney disease, also called diabetic nephropathy, occurs when the filtering apparatus of the kidney stops working properly. The glomerulus acts like a strainer that filters waste products from the blood. The waste products are stored in the bladder and expelled through urine. Useful substances, such as protein, stay in the blood and are used by the body to build and repair tissues, and make enzymes, hormones, and other body chemicals.
A person with uncontrolled diabetes has high blood sugar, which damages the glomerulus. As a result, protein begins to leak through the filter and ends up in the urine. If diabetic kidney disease is not treated, larger and larger amounts of protein leak into the urine. If too many waste products start to build up in the blood, the kidneys fail, requiring dialysis or a kidney transplant.
Which Medications Are Used To Protect The Kidneys
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers
Medications that lower blood pressure also help slow kidney disease. Two types of blood pressure medicines, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers , play a special role in protecting the kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure.
These medications either prevent or block a hormone that tells blood vessels to tighten, which allows the blood vessels to open and thus reduce blood pressure. For most people with diabetes, a blood pressure target of less than 130/80 mm Hg is sufficient for kidney protection. Both ACE inhibitors and ARBs can reduce the risk of developing kidney disease in diabetes, independent of their effect on blood pressure, and they can also protect against the progression of kidney disease.
Is special monitoring required for these medications?
It is important that people with diabetes who are taking an ACE inhibitor or ARB have their serum creatinine and potassium levels checked within one to two weeks of starting the medication, when the dosage is increased, or during times of acute illness.
This is important because your healthcare team needs to check your eGFR . Your eGFR is a number based on your blood test for creatinine.
Sodium-glucose co-transporter-2 inhibitors
What is the effect of SGLT2 inhibitors on kidney health?
More Information And Support About Kidney Disease
Talk with your diabetes team. They should be able to answer most of your questions. And we’re here to provide support and information when you need it too.
If you have more questions, or just want someone to listen, give our helpline a call. You’ll be able to talk things through with highly trained advisors who have counselling skills and an extensive knowledge of diabetes.
The National Kidney Federation have kidney disease leaflets and can put you in touch with a local group. Kidney Care UK also offers resources and support including a telephone counselling service that you may find useful.
Kidney Research UK are dedicated to research into kidney disease. We’ve been working together to identify the most important areas of future research, so that we can ultimately stop kidney disease in people with diabetes.
Diabetes: 5 Natural Drinks To Protect The Kidneys
Maintaining adequate hydration is of utmost importance for the good control of diabetes and adequate protection of kidney function.
Photo: Photo de Ylanite Koppens and Pexels / Pexels
Today’s lifestyle and diet quality are factors that considerably increase the risk of type 2 diabetes. Especially in people over 40, it has become less surprising and more unavoidable. Fortunately, thanks to modern medicine and appropriate dietary adjustments, living with it has become easier. However when left unchecked, diabetes can cause many other conditions, such as kidney disease. It is a kidney disorder in which antibodies called IgA build up in kidney tissue and is a condition that refers to kidney damage, disease, or other abnormalities. It is estimated that almost a third of diabetics, that is, 1 in 4 adults with diabetes develop this condition.
The diabetic kidney disease It occurs when poorly controlled blood sugar damages the blood vessels in the kidneys. This also leads to high blood pressure, and high blood pressure further damages the kidneys by increasing pressure in the kidney’s delicate filtering system called glomeruli. The truth is that people with type 2 diabetes are more likely to have kidney disease when they are diagnosed with the disease. This is called partial kidney function.
Easy Tips To Prevent Kidney Diseases In Diabetics
3 Easy Tips To Prevent Kidney Diseases in Diabetics
Kidneys are one of the most vital organs of our body, responsible for waste management. Their function helps maintain the blood pressure and chemical balance that the body requires to function without any issues. Any dysfunctionality in the kidneys may lead to a number of health problems, some of which may even result in organ failure. Kidney stones, urinary tract infection and hypertension are some of the common kidney diseases that many suffer from in today’s time.
Another major disease that is strongly associated with kidneys is diabetes. Diabetes is the leading cause of kidney disease, across the globe. Although the modern medicine has made things easier, when left unchecked, diabetes can lead to serious kidney problems such as diabetic nephropathy. It refers to a grave kidney related complication of the Type 1 and Type 2 diabetes. The best nephrologists in India would inform you that it is better to prevent the development of such a medical condition rather than having to deal with the results of the disease later.
Let’s take a look at some easy ways to prevent diabetic nephropathy and maintain your kidney health.