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Checks and balances for hypertensive diabetics

Published - December 29, 2010 10:37 am IST - HYDERABAD:

They need to maintain ‘below normal' blood pressure: experts

There is a growing pool of diabetics in the twin cities, who, due to lack of awareness on management of their condition, suffer from various kidney ailments, sometimes even kidney failure.

Most of them also have high blood pressure (hypertension), which if not kept under check, will accelerate the kidney disease.

So what does a diabetic, who is also hypertensive, do to avoid kidney ailments or failure?

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First step

As a first step towards that, diabetics will have to control sugar levels and maintain ‘below normal' blood pressure. For that to happen, physicians suggest a multipronged approach that includes medication and tweaking lifestyle that includes a healthy diet and avoiding addictive substances.

Common complication

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The most common renal complication among sugar patients is diabetic nephropathy, a condition in which kidneys get progressively damaged.

Among type-2 diabetics, the prevalence rate of kidney ailments is 50 to 60 per cent while for a typical type-1 diabetic usually develops nephropathy after a period of 20 years.

“Holistic approach is the only way to protect kidneys. Blood pressure should always be maintained ‘below normal'. Serum and potassium levels have to be monitored at least once in two months. Importantly, doctors should tell mandatory precautions to patient,” says senior Nephrologist Dr. Pradeep Desphande.

Uncertainty

A majority of patients are often uncertain on how diabetes impact kidneys? Kidneys have small filtering units called ‘glomeruli', that get progressively damaged due to diabetes.

The damage to glomeruli leads to large amounts of protein being found in urine. Physicians also inform that diabetes impact nerves and triggers urinary tract infections.

“Smoking damages blood vessels in kidney. Diabetics who smoke should stop smoking completely,” warns R. Ram, Assistant Professor, Nephrology, Nims Hospital.

Controlling BP

Many patients are also clueless on measures to control blood pressure. High blood pressure among diabetics is usually defined as blood pressure that exceeds 130/85 mm Hg (millimetres of Mercury).

“That level should be low because higher levels accelerate kidney damage. Patients should take ACE inhibitor and ARB based drugs to control blood pressure,” doctors suggest.

High risk factors

The high risk factors for kidney damage among diabetics include high sugar levels, high blood pressure, smoking, family history and obesity, say doctors.

“These are just high risk factors and it is possible that patients with no such risks also develop kidney ailment,” Dr. Ram says.

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