In India, the burden of diabetes kidney disease is increasing rapidly due to the high and increasing proliferation of type 2 diabetes mellitus. According to the Indian Council of Medical Research (ICMR), about 25–30% of people with diabetes in India develop kidney damage to some extent.
In an interview with HT lifestyle, Dr. Rajiv Kovil, the head of diabetes and co-founder of Rang de Neela Pahal in Rajiv Kovil, Zandra Healthcare claimed, “The initial identity of renal disease in diabetes is important to delay its progress for kidney failure and most people suffering from kidney disease in diabetes eventually die in heart disease.”
He explained, “Podocytes are special cells in the kidney tissue, called glomerular, which play an important role in maintaining filtration barrier. In T2DM, frequent hyperglycemia podocyte injury, loss and eventually, protein in urine is leaked. Podocyte loss is an early marker of diabetic kidney disease, often occurring before a significant decrease in kidney function. ,
Dr. Rajiv Kovil explained in detail, “Urine albumin-to-creatinine ratio (UACR) is a major clinical marker that can detect early kidney damage. An elevated UACR (> 30 mg/g) indicates albuminuria, which is the early identity of kidney disease.
Initial treatment strategies
Dr. According to Rajiv Kovil, initial treatment with the aim of reducing UACR can significantly slow the progress of kidney disease in strategies –
- Patients with diabetic kidney disease are often present with proliferative diabetic retinopathy (PDR) or diabetic macular edema (DME) and vice versa. Management of blood pressure, blood sugar, and kidney function can reduce the risk of retinopathy progression in patients with diabetes with CKD.
- Sodium -Glucose Cotransporter -2 (SGLT2) inhibitors have emerged as a revolutionary class of drugs in the management of both diabetes and CKD. SGLT2 inhibitors, such as Empagliflozin, dapagliflozin, and canagliflozin, work by blocking glucose regenerations in the kidney, which leads to glucose emissions and osmotic diarrheis, resulting in avoiding progressive damage as a result of this mechanism.
Major benefits of SGLT2 inhibitors in CKD with diabetes:
1. Reduction in albuminuria: Studies such as EMPA-Kidney and DAPA-CKD tests demonstrated significant cuts in albuminuria, slowing down CKD progression.
2. Protection of kidney function: Long -term use of SGLT2 inhibitors reduces the fall in the estimated glomerular filtration rate (EGFR).
3. Heart safety: SGLT2 inhibitors also reduce heart incidences, a major cause of mortality in diabetes kidney disease.
4. Delay in dialysis or kidney failure: SGLT2 inhibitors help delay the onset of ESRD by reducing intraglomerular pressure.
Dr. Rajiv Kovil said, “Chronic kidney disease type 2 remains a major complexity of diabetes, which has significant sickness and mortality. Early detections through UACR and managing proteinuria are the strategy required to slow down the decline in kidney function. ,
He concluded, “The arrival of SGLT 2 barriers has revolutionized diabetic kidney disease by reducing albuminuria, preserving renal work and offering cardiovascular safety. As the burden of diabetes increases in India, widely adopting SGLT2 inhibitors, routine screening, and early intervention can reduce the progression of CKD to a large extent in diabetes, which can improve the patient’s results and improve the quality of life. ,
Note the readers: This article is only for informative purposes and is not an option for professional medical advice. Always consult your doctor with any question about a medical condition.
