Diabetic nephropathy: most effective dietary supplements

Diabetic nephropathy is a serious microvascular complication of diabetes, mainly related to chronic hyperglycemia. It is characterized by progressive damage to the kidneys, which can lead to end-stage renal disease. Diabetes is, in fact, the leading cause of kidney failure in Europe and in many other regions of the world. This condition affects the renal glomeruli, the kidney's filtration units, and is manifested by abnormalities in glomerular filtration and increased excretion of proteins in the urine.

Pathophysiology

The pathophysiology of diabetic nephropathy begins with glomerular hyperfiltration and renal hypertrophy in response to chronic hyperglycemia. This hyperfiltration, combined with increased glomerular pressure, causes damage to the glomerular capillaries and increased permeability to albumin. Gradually, this damage leads to microalbuminuria, which can progress to macroalbuminuria and, ultimately, chronic kidney disease. Renal lesions are also characterized by thickening of the glomerular basement membrane and mesangial expansion, which contribute to the progressive decline in kidney function.

Risk factors

• Duration of diabetes: The longer the duration of diabetes, the greater the risk of nephropathy. • Poor glycemic control: Poorly controlled blood glucose is a key determinant. • High blood pressure: Hypertension worsens kidney damage. • Genetic predisposition: Some individuals have an increased genetic susceptibility. • Smoking: Tobacco increases the risk of microalbuminuria. • Dyslipidemia: Abnormal blood lipids are also involved.

Symptoms

Diabetic nephropathy is often asymptomatic in its early stages. Symptoms usually appear when the disease is already advanced. Common findings include: • Edema, often around the eyes or in the lower limbs. • High blood pressure, sometimes difficult to control. • Proteinuria detectable on a urine dipstick. • Fatigue, nausea, and other signs of advanced renal failure.

Diagnosis

The diagnosis of diabetic nephropathy is based on the detection of microalbuminuria, followed by macroalbuminuria. Routine tests include: • Urine dipstick: For early detection of proteinuria. • Albumin/creatinine ratio: To confirm the presence of microalbuminuria. • Renal needle biopsy: Rarely performed, except in cases of uncertain or atypical diagnosis.

Treatment

• Tight glycemic control: To prevent disease progression. • Blood pressure control: Often with angiotensin-converting enzyme (ACE) inhibitors. • Low-protein diet: To reduce the load on the kidneys. • Monitoring of kidney function: Dose adjustments of medications based on the glomerular filtration rate. • Management of other risk factors: Such as smoking cessation and control of blood lipids.