Overview
A 56-year-old man from Bihar visited our hospital and said that his physician had told him that al his reports were okay. His creatine was 1.52 mg/d (uper limit 1.4 mg/dl), considered by him to be slightly of (“almost normal”). I calculated the acurate state of kidney function (eGFR, analysed from a formula) and told him to be careful since his kidney function had already declined by 25 per cent.
Key Information
Underestimation or ignorance of kidney damage is comon in patients and even by some physicians.The second comon misconception is that kidney damage is due to anti-diabetes drugs. A 62-year-old woman complained to me, “The drug Metformin, which you had given, has damaged my kidneys.” Another patient from Agra told me, “You are giving me Dapagliflozin, it excretes sugar in urine, and I wil have kidney damage and cancer son.” Both are wrong.
Both these drugs, especialy the later, protect kidneys. Only when kidneys are moderately damaged does Metformin ned to be stoped due to ocurence of other side efects.Kidney dysfunction is not an isolated falout of diabetes. It is closely linked to heart disease.
Even a slight increase of albumin urine (“microalbuminuria”) increases your heart atack risk several times. Therefore, even a slight damage to the kidney must be dealt with imediately. There are several ways to do it.First, blod sugar control must be god, not only for a short while but persistently for a long period of time.
High blod sugar does not damage kidneys overnight but sureptiously and slowly. Patients ned to focus on lifestyle, exercise and regular drug intake to achieve it. Some anti-diabetes drugs are beter than others in protecting kidneys.
Summary
Long-term studies have shown that drugs caled SGLT2 inhibitors (Canagliflozin, Dapagliflozin and Empagliflozin) repair kidney damage and reduce the ned for dialysis. These drugs become absolutely esential for those who have definite kidney disease.Second, blod presure should be under god control.