Diabetes and kidney issues: Understanding the risk of diabetic nephropathy

Diabetes is a growing public health concern in India, affecting over 100 million people, and Gujarat is no exception. These growths are incredibly common, affecting women by the time they reach their reproductive age. Although many women with fibroids experience no symptoms at all, for some, fibroids can cause a range of significant and distressing problems.

The Indian Council of Medical Research (ICMR) reports that uncontrolled diabetes is a cause of kidney disease. In 2023, the ICMR-INDIA study found that the prevalence of diabetes in India was 10.1 crores. Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease (CKD) and end-stage renal disease. DKD develops in about 40% of people with type 2 diabetes and 30% of those with type 1 diabetes.

At KD Hospital, Ahmedabad, we've witnessed a sharp rise in cases where diabetes silently damages the kidneys, eventually leading to chronic kidney disease (CKD) or even end-stage renal failure.

KD Hospital has successfully treated patients with diabetes-related kidney complications, offering state-of-the-art diagnostic and treatment options under one roof. This blog aims to raise awareness about the intricate connection between diabetes and kidney health—and how early intervention can change lives.

The connection between diabetes and kidney disease:

The kidneys are essential for filtering waste and excess fluid from the blood. In people with uncontrolled or long-term high blood sugar damages the small blood vessels in the kidneys, impairing their filtering ability. This condition is known as diabetic nephropathy, and it is one of the leading causes of chronic kidney disease (CKD).

According to the Indian Journal of Nephrology, diabetes accounts for nearly 40% of all kidney failure cases in India.

What is diabetic nephropathy?

Diabetic nephropathy is a chronic and progressive kidney disease caused by prolonged high blood sugar levels, which damage the glomeruli—the tiny filtering units within the kidneys. It usually develops over years, often without symptoms in the early stages.

Stages of diabetic kidney disease:

• Stage 1: Increased kidney filtration (hyperfiltration), no symptoms
• Stage 2: Slight protein in the urine (microalbuminuria)
• Stage 3: Moderate protein loss, slight kidney function decline
• Stage 4: Heavy proteinuria, decreased filtration rate
• Stage 5: Kidney failure or end-stage renal disease (ESRD) – requires dialysis or kidney transplant

Early diagnosis is crucial. At KD Hospital, we offer routine urine albumin tests, serum creatinine measurements, and eGFR screenings as part of our diabetes care program to detect early signs of kidney involvement.

Why are diabetics at risk for kidney problems?

Several factors contribute to kidney disease in diabetic patients:

• High blood sugar levels damage blood vessels and the kidney's filtration system.
• Hypertension (high blood pressure), which is common in people with diabetes, can significantly accelerate kidney damage.
• Obesity and insulin resistance increase the strain on kidney function.
• Smoking and a sedentary lifestyle worsen diabetes control and kidney health.

At KD Hospital, we focus on multidisciplinary care, where diabetologists, nephrologists, and dietitians collaborate for comprehensive management.

Symptoms of kidney issues in diabetics:

Diabetic kidney disease often progresses silently in the early stages. However, as the damage advances, symptoms may include:

• Swelling in ankles, feet, or hands
• Increased urination, especially at night
• Frothy or foamy urine (proteinuria)
• High blood pressure
• Fatigue, nausea, or vomiting
• Poor appetite
• Shortness of breath
• Confusion or drowsiness

KD Hospital encourages annual screening for all diabetic patients to detect kidney issues before symptoms arise.

How we diagnoses kidney problems in diabetics?

At KD Hospital, we use evidence-based protocols and advanced diagnostic tools to monitor and manage diabetic nephropathy, including:

• Urine albumin-to-creatinine ratio (UACR): Detects protein leakage
• Serum creatinine and eGFR tests: Evaluate kidney function
• Kidney ultrasound: Assesses structural abnormalities
• 24-hour urine protein analysis: For severe or advanced cases

Treatment and management of diabetes-related kidney disease:

While kidney damage is often irreversible, early treatment can significantly slow progression. At KD Hospital, our integrated approach combines:

• Optimal blood sugar control:
  Glycemic control reduces the risk of complications. We tailor diabetes management plans using the following:
  • Insulin therapy
  • Oral hypoglycemic agents
  • Continuous glucose monitoring (CGM)
  • Personalised nutrition counselling
• Blood pressure management:
  Maintaining blood pressure below 130/80 mmHg is essential. Our nephrologists commonly prescribe:
  • ACE inhibitors or ARBs – both protect kidneys and control blood pressure
  • Diuretics if fluid retention is present
  • Regular blood pressure monitoring with home-based follow-ups
• Renal diet and lifestyle changes:
  KD Hospital's clinical dietitians guide patients on:
  • Low-sodium, low-protein diets
  • Limiting potassium and phosphorus in advanced stages
  • Staying hydrated and avoiding processed foods
  • Encouraging daily physical activity and weight control
• Advanced medication options:
  We also prescribe SGLT2 inhibitors (e.g., empagliflozin) and GLP-1 receptor agonists (e.g., liraglutide) for their proven renal protective effects.
• Dialysis and transplant:
  For patients with advanced kidney failure, KD Hospital offers:
  • Hemodialysis and peritoneal dialysis units with round-the-clock care
  • Kidney transplant services with pre-and post-operative management
  • Psychological and nutritional support for patients and caregivers

Why choose KD Hospital for diabetes and kidney care?

• Multi-specialty approach: Coordinated care from top diabetologists, nephrologists, and endocrinologists in Ahmedabad
• State-of-the-art dialysis centre with infection-controlled environments
• Patient-first philosophy with individualised care plans
• Comprehensive diagnostics, counselling, and follow-ups under one roof

KD Hospital is recognised as a leading centre for diabetes and kidney care in Gujarat. Our patients benefit not only from cutting-edge treatment but also from compassionate, evidence-based support every step of the way.

Preventing diabetic kidney disease:

Prevention remains the best cure. Diabetes can reduce the risk of kidney problems by:

• Controlling blood sugar levels.
• Keeping blood pressure in check.
• Quit smoking.
• Following a healthy, kidney-friendly diet.
• Staying physically active.
• Getting annual kidney function tests.
• Taking medications as prescribed.

KD Hospital runs regular awareness programs and diabetes education workshops to empower patients with knowledge and self-care strategies.

Best kidney care and transplant hospital in Gujarat.

In a nutshell:

The link between diabetes and kidney disease is both alarming and under-recognised. At KD Hospital, Ahmedabad, we believe in early intervention, patient education, and comprehensive care to tackle this rising health challenge. Whether you are newly diagnosed with diabetes or have been managing it for years, regular screening and proactive care can prevent kidney complications.