Is Dialysis Inevitable for Diabetics

Diabetes Mellitus is always called Silent Killer due to its severity and latent complications. Once someone gets Diabetes, various complications are just around the corner. Among them, Diabetic Nephropathy is always attached much importance to, and finally the dialysis become inevitable if there is no effective treatment in time. Is dialysis really inevitable for Diabetes? We get some knowledge of Diabetes and Diabetic Nephropathy first.
Diabetes is characterized by the retention of blood glucose in human body which is aroused by the decreased function of pancreas and the insulin resistance. During the course, kidneys are always involved in. When there are some pathological changes in kidney, we can find the basilar membrane become broad, accompanied by proliferation of mesangial cells and the hyperplasia of extracellular matrixes in glomeruli, and also the broadening and nodosity of glomerular capsules.
There is no exact reason to explain the involvement of kidney during Diabetes. However, according to the study of pathology, we can illustrate it in the following way.
The key reason can be abnormal hemodynamics in kidneys. When the level of blood glucose is higher, the glomeruli will be in a situation of high perfusion and high filtration, so the pressure in capillaries will rise and epithelial cells in glomeruli will drop as well. Also, the type IV collagen in basilar membrane become more, so the mesangial area broadens and glomeruli are sclerosed. Meanwhile, excessive protein accumulates in basilar membrane, promoting the proliferation of extracellular matrixes. What's more, the genetic history and high blood pressure are the influencing factors for diabetics to develop Diabetic Nephropathy.
Once the kidneys are involved in the Diabetes, the course of it can be divided into five stages. In the early stages, say, the stage 1, 2, and 3, The Glomerular Filtration Rate (GFR) is at first higher and become normal later then; the disease condition can be reversed if effective treatment can be provided, and if no, more than 90% of the suffers can become the really obvious Diabetic Nephropathy. Then, it progresses into clinical Diabetic Nephropathy during which the GFR decreases accompanied by Hypertension in most cases, and If the blood pressure cannot be controlled well, the GFR will deteriorate rapidly, so that the suffers will develop Kidney Failure within 5-8 years, that is to say, in the end stage of Diabetic Nephropathy. The GFR decreases to be less than 10ml/min; the levels of urea nitrogen and creatinine increase; edema and Hypertension aggravate further, and Hypoproteinemia will appear. What's worse, retinal changes and nerve changes will come together with the Diabetic Nephropathy in many cases. Generally speaking, when the patient is in his stage 4, the serum creatinine will be higher than 400umol/L. In stage 5, the level of creatinine and blood urea nitrogen (BUN) rises obviously, and when the creatinine is as high as 700umol/L, dialysis is inevitably necessary because almost all the kidney functions are lost already.
Here is the summarized introduction from which you can know how the Diabetes develops into Diabetic Nephropathy, and how the dialysis become inevitable. In the end stage of Diabetic Nephropathy, kidneys lose most functions so all the wastes in human body need to be excreted outside with the help of dialysis. From all those mentioned above, we can know the importance of effective and timely treatment for Diabetes. Only when the condition is controlled in the early stages, can the progress be decelerated. Also, when effective treatment can be provided, the dialysis can be avoided thereby.