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March 2007 Issue

UC nephrologists and diabetes specialists are working to reduce the incidence of chronic kidney disease in diabetics. Their plans include carefully regulating medications to control blood pressure and protein levels.
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Preventing Diabetic Kidney Failure

By Amanda Harper
Published March 2007

Kidney specialists at UC say a collaborative approach to care that includes early intervention can help prevent kidney failure in diabetes patients.

Nephrologists Janet Boyle, MD, and Kotagal Kant, MD, have teamed up with the multidisciplinary team at the UC Diabetes Center to identify people at high risk for chronic kidney disease. Their goal is to implement early-intervention medical treatments that will help postpone disease onset.

“Diabetics are more prone to develop renal disease because their kidneys’ ability to filter harmful substances from the blood is already severely impaired,” says Boyle, assistant professor of medicine at UC.

“The idea is to catch and begin treating kidney problems as soon as possible—in the early stages of disease—so we can prolong kidney function and give patients a better quality of life.”

Located near the middle of the back, kidneys are bean-shaped organs that keep the body’s blood supply clean and chemically balanced by filtering out waste products and excess water.

The National Institute of Diabetes and Digestive and Kidney Diseases estimates that more than 8 million adults have chronic kidney disease. This condition, which causes gradual loss of kidney function, can be “silent” for many years prior to diagnosis.

Kant and Boyle believe a proactive, multidisciplinary approach to diabetic care that involves nephrologists, diabetes specialists and nurse educators can slow the progression of—and possibly even eliminate—chronic kidney disease in people living with diabetes.

Research has shown that early diagnosis and careful control of blood glucose (sugar) levels and blood pressure, combined with certain medications used to control diabetes, can lessen the severity
of kidney disease for diabetic patients.

“If we prescribe the right balance of medications to manage high blood pressure and reduce the amount of protein in their urine,” adds Boyle, “we can preserve kidney function and help diabetes patients live longer.”

Kant estimates that more than 1 million people will receive regular dialysis to treat chronic kidney
disease by 2010. If their diabetes is left unchecked, he says, most patients will develop chronic kidney disease within several years of a diabetes diagnosis.

“But with strategic medical management of the disease, we may be able to eliminate the need for dialysis in people with chronic kidney disease,” adds Kant. “That would help reduce health care costs and improve the lives of thousands of people.”

According to the American Diabetes Association, more than $92 million is spent in the United States each year on direct medical costs associated with diabetes, and more than 153,000 people are living on chronic dialysis or a kidney transplant due to diabetes-related kidney disease.

Physicians stress that there are no definitive signs of chronic kidney disease, but people with diabetes and high blood pressure are at greater risk.

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