“Dumb organs” tell three unexpected signals

Studies have shown that about 1/3 of diabetic patients will develop diabetic nephropathy. Diabetic nephropathy is one of the microvascular complications of diabetes patients. It develops slowly. Since patients do not have any discomfort symptoms in the early stages, when they go to the hospital for examination, they have often developed to the point where protein appears in the urine or blood creatinine has increased. Therefore, the kidneys are famous as "dumb organs". March 12 this year marks the tenth World Kidney Day. We would like to remind all diabetics to be alert to the three most unexpected signs of kidney disease and strive for early detection and diagnosis.

Accident 1: Sleep apnea may damage kidneys!

For people with diabetes, having both kidney disease and sleep apnea may cause kidney disease to progress faster, according to a new study.

Screening for sleep disorders may help detect people at risk for accelerated loss of kidney function, the researchers say.

According to the researchers, obstructive sleep apnea is common in people with type 2 diabetes. This disorder causes the soft tissue at the back of the throat to block the upper airway during sleep. This leads to breathing pauses and other symptoms such as wheezing and snoring.

According to background information in the study, people who have both type 2 diabetes and chronic kidney disease (CKD) are at greater risk.

The study, led by Dr. Roberto Pisoni of the Medical University of South Carolina, examined whether sleep apnea is associated with the development of diabetes and kidney disease.

Their study included 56 patients with both diabetes and kidney disease. The patients completed a questionnaire designed to screen for sleep apnea. The study showed that 61% of patients scored high on a screening survey for sleep apnea. These patients had worse kidney function than other patients with low sleep apnea scores.

"This study demonstrates that high risk scores for obstructive sleep apnea are prevalent in non-dialysis CKD patients with diabetic nephropathy and are associated with a more rapid loss of renal function," the researchers wrote. "This simple approach could identify patients at higher risk for CKD progression."

While the researchers found an association between sleep apnea and decreased kidney function in people with diabetes, their study did not prove a cause-and-effect relationship.

The findings were presented Friday at the American Society of Nephrology's annual meeting in Philadelphia. Research is presented at a scientific meeting and should be considered preliminary until published in a peer-reviewed medical journal.

Accident 2: A pit is formed when the leg is pressed. Diabetics should check their kidneys immediately

“Why are my legs so swollen? There’s a dent when I press them.” Aunt Huo, a diabetic, found that her calves were always swollen and there was a dent when she pressed them. She was very puzzled. When she went to the hospital for a check-up, she discovered something bad had happened: it turned out she had diabetic nephropathy. Now is a good season to nourish the kidneys, so how can diabetics protect their kidneys and prevent diabetic nephropathy?

Aunt Huo is a diabetic who has been suffering from the disease for 11 years. She never thought that she would develop diabetic nephropathy. In this regard, Yang Aige, deputy director of the Endocrinology Department of the First Hospital of Hebei Medical University, said that it was because Aunt Huo did not monitor and control her blood sugar properly that she got into this big trouble. Blood sugar control has the greatest impact on the occurrence of diabetic nephropathy. For diabetics, protecting their kidneys and controlling blood sugar are the most important things.

Yang Aige introduced that if diabetics also have diseases such as high blood lipids or high blood pressure, these factors will also increase the occurrence of other complications. However, if diabetics control their blood sugar well, they can not only prevent diabetic nephropathy, but also various other complications.

Accident 3: Abnormal increase in the number of nighttime awakenings. Diabetics should check their proteinuria quickly.

In general, nocturia in diabetic patients refers to an abnormal increase in urine volume or frequency of urination at night. A healthy person urinates about 1.6 liters every 24 hours. The ratio of day to night urination frequency is 3-4:1 for teenagers, 1:1 for middle-aged people, and 1:3 for the elderly over 70 years old. If the amount of nocturia is greater than 1/2 of the total urine volume in a day or the ratio of urination frequency during the day and at night decreases, it is considered nocturia. As the amount of nocturnal urination increases, the frequency of nocturnal urination also increases. In mild cases, the patient may have to get up 2 to 3 times at night, and in severe cases, the patient may have to get up more than 10 times. This often leads to patients' lack of sleep, decreased energy, loss of appetite, anxiety, irritability, and mental depression. These can be common causes of uncontrollable high blood sugar, and therefore should be taken seriously and treated actively.

In many cases, proteinuria is the only early symptom of diabetic nephropathy. Testing urine microalbumin and urine protein is an effective way to detect this fatal complication early. However, a single abnormal amount of albumin in urine sometimes does not mean a problem. It may temporarily increase in cases of sharp increase in blood sugar, physical exercise, urinary tract infection, high blood pressure, heart failure, acute fever, etc., so it should be checked again two or three times. If the levels are between 30 and 299 mg/day, it means there is trace albumin in the urine and there are signs of diabetic nephropathy.