It’s National Kidney Month!

Posted on March 4, 2014 by American Diabetes Association
March is National Kidney Month, a time to raise awareness about the prevention and early detection of kidney disease. Did you know that diabetes is the leading cause of kidney failure? The good news is that managing your diabetes well can help improve your health outcomes.

So how does diabetes cause kidney disease? The process goes like this: When our bodies digest protein, the procedure creates waste products. In the kidneys, millions of tiny blood vessels with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.

Diabetes, both type 1 and type 2, can damage this system. High levels of blood glucose cause stress on the filtering system in the kidneys. After many years, they start to leak, and things like protein that are supposed to stay in the bloodstream are lost in the urine. Having small amounts of protein in the urine is called microalbuminuria. This damage happens without any symptoms.

In time, the kidneys stop working well. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, end-stage renal disease (ESRD), is very serious and requires a kidney transplant or dialysis.

Whew! Still with us? We hope so, because as mentioned above, the better a person keeps diabetes under control, the lower the chance of getting kidney disease. Research has shown that tight blood glucose control reduces the risk of microalbuminuria by one third. Other studies have suggested that tight control can even improve microalbuminuria.

Since there are usually no symptoms associated with early kidney failure, lab tests are essential. If you have diabetes, talk to your health care provider about how often you should be tested. This can be done by either a blood test or a urine test.
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Risks to Bone Health in Treating Chronic Disease in Younger Patients

The Wall Street Journal
By LAURA LANDRO

Osteoporosis, a loss of bone strength that raises the risk of fractures, is one of the most common and crippling ailments associated with aging in women. Increasingly, it is striking younger patients who have a host of other medical problems.

Researchers call it secondary osteoporosis. They are identifying a growing list of factors that contribute to bone deterioration, including chronic diseases and some of the powerful drugs used to treat them. Alone or in combination, disease and medication can interfere with the way the body naturally breaks down and rebuilds bone tissue, and how well it absorbs bone-building nutrients like calcium and Vitamin D.

Because there often are no symptoms as bone weakens, osteoporosis often hasn’t been diagnosed until a patient suffers a fractured bone.

Now, bone health experts are calling for greater efforts to identify patients earlier who are at risk for secondary osteoporosis, before their bones become more fragile and further raise their risk of injury and disability.

Recommended measures include bone mineral density scans for patients who wouldn’t ordinarily get routine screening, treatment of underlying diseases that contribute to bone loss, lifestyle changes and calcium and vitamin D supplements. Doctors also are prescribing osteoporosis medicines shown to slow bone loss or build new bone.

Secondary osteoporosis is increasingly being diagnosed in younger patients with cancer, celiac disease, rheumatoid arthritis and inflammatory bowel disease, as well as in people taking reflux medications, blood thinners and some depression drugs, researchers say. Patients are at risk of secondary osteoporosis after bariatric surgery for weight loss, as are those receiving hormonal treatments to prevent the recurrence of breast or prostate cancer.

Adverse effects of diabetes on bone health are starting to be recognized. Smoking, excessive alcohol use, eating disorders like anorexia nervosa and inactivity are also linked to declining bone mass.

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