Kidney Failure

Speaker: Kidney failure or diabetic nephropathy. Jim: Being in there with an ammonia on dialysis, that’s almost like you are next. Jamie: He had noticed some protein in my urine and some in my blood tests it was enough cause for concern that they started me on the appropriate medications to help prevent if not slow down the kidney disease process. Speaker: The purpose of the kidneys is to filter the blood, excreting waste into the urine while conserving blood cells and vital proteins. Over time, poorly controlled diabetes can damage your kidneys. As a result, the essential proteins are lost in the urine and waste products accumulate in the blood. Left untreated, kidney failure will result in death. Dr. Duggan: On a daily basis, I look after both patients who are already on dialysis as well as people who are approaching the need for dialysis. About 50% of the people I see have kidney disease from their diabetes. Dr. Hobart: The long-term complications of diabetes of course is a systemic disease and it can affect many different parts of the body. Whether it effects the kidney there is a gradual decline in renal function. This can be seen through urine tests and blood tests. Dr. Duggan: In my special view the thing that really matters is knowing whether or not you have kidney disease as well as really controlling your blood pressure and your blood sugar and those are basic things that will help prevent any of the complications of diabetes. But I think it’s really important that people as soon as they are diagnosed learn as much as possible about their disease, they go to a diabetic clinic, that they get diet therapy, that they learn how to control their blood sugars whether it be on insulin or pills. So that’s probably the most important thing is that people learn all about their disease. From my perspective, certainly then I want to take it a step further and teach them that they need to be having blood test and urine test on a regular basis as well as really being aggressive in checking their blood sugars and monitoring their blood pressure. Jamie: I see a kidney specialist quite often and she is wonderful, she is wonderful at explaining everything to me. I wouldn’t have it any other way. She shows me all the numbers. Jim: I went into renal failure and so I chose haemodialysis so I was on dialysis for two years. Dr. Duggan: Once you develop significant kidney disease, it impacts upon your life significantly not only does it mean that you need to come for dialysis, but it also is a marker in terms of how poor your health is and so there are things that patients can do to try and prevent the development of kidney disease as well as delay the progression so that they stay off dialysis an extra five years which is an important thing. Nina Hardin: I see a lot of people who are in renal failure, kidney failure and they have just started dialysis if they are going to be starting dialysis and it's really sad because they are so young and they have so much to really to deal with. Speaker: In extreme cases, life saving dialysis maybe required to mechanically cleanse the blood and occasionally, a kidney transplant maybe required. Dr. Hobart: Treatment for end stage renal disease would require haemodialysis, peritoneal dialysis or renal replacement with renal transplantation. Renal transplantation should not be viewed as a cure for renal failure, but its maybe one different treatment option for end stage renal disease. Nina Hardin: Many of them have had kidney transplants and they do amazingly well. So I have always felt proud of them either which way I mean, I know that they need help all the way along, just someone to talk to, someone to give them advice, someone to help them along. While, some of them are crazy that they are following and they are just – many of them that I have seen have done very, very well. Speaker: Both your diabetes and your blood pressure must be well controlled to prevent kidney damage. The presence of protein in the urine known as microalbumin is an early indicator of kidney disease. Your urine should be checked annually for the presence of protein with a test known as an albumin:creatinine ratio. Your blood should also be checked for a rising creatinine level. Creatinine is a waste product normally excreted in the urine. At your doctor's discretion, other tests maybe required.