When should People with Diabetic Nephropathy Start Dialysis

Diabetes is rising in recent years as an important leading cause of chronic kidney disease. For people with Diabetes, early detection and preventive measures to slow down damage on the kidneys and prevent occurrence of kidney failure is important for the patients. When Diabetes causes severe renal damage and elevates people’s serum creatinine level, the question as to when is the proper time to do dialysis becomes the concerned issue among the patients.

Generally, doctors will evaluate patients’ general condition such as residual renal functions, serum creatinine level and accompanying symptoms/complications to make sure whether there is need to start dialysis. Diabetic Nephropathy, secondary kidney disease to Diabetes, tends to progress faster and appear more complications than other types of kidney disorders.

Diabetes impairs filtering cells of the kidneys, and at initial stage people will experience proteinuria. Diabetic Nephropathy in its developing process is often combined with other diabetic complications such as retinopathy, foot disease, neuropathy, etc. When the disease develops into advanced stages, kidney disease itself can worsen diabetic problems such as cardiovascular complications, Autonomic Neuropathy, gastrointestinal tract disorders, etc.

The above is one of the important reasons why people with Diabetic Nephropathy often start dialysis earlier than other kidney diseases. In normal case, indicator for dialysis is serum creatinine over 707mmol/l or glomerular filtration rate (GFR) less than 10. In diabetic nephropathy, however, their serum creatinine level can not reflect the real renal condition. And complications tend to occur much earlier and severer. So even if people’s glomerular filtration rate (GFR) is higher than 10mmol or even 15mmol/l, if they have severe complications such as retinopathy, brain disorder, heart disease, they also need to start dialysis immediately.

According to some researches, earlier starting dialysis helps to slow down progression of Diabetic Retinopathy and damage to other vital organs. Either it is peritoneal dialysis or hemodialysis, the time to initiate dialysis is earlier than non-diabetics. One thing to know is that, dialysis treatment is a way to discharge toxins out of bloodstream and relieve complications; however, it doesn’t help in treating the kidneys. A person with advanced diabetic kidney disease, on one hand, may remit the general condition by dialysis; on the other hand, should treat kidneys positively and not rely on dialysis as a only treatment because long-term of dialysis causes remaining functioning renal cells get atrophied gradually over time.