Le diabète, la recherche et l'accompagnement.
Diabetes, Research and Support
Diabetes and hypertension, causes of kidney failure
A net increase in disease
The number of patients with acute renal disorders is increasing in recent years. This trend is related to the increase of chronic diseases which may be responsible for renal failure. Among these diseases, diabetes and hypertension form the leaders in reporting together 50 to 60% of cases of kidney failure. In recent years, other causes of renal failure have emerged, such as kidney diseases associated with heart failure or disease of the great vessels and means (cardio-renal syndrome and vascular nephropathy). Their frequency is rising sharply.
There are many other possible causes of kidney failure. In rare cases, some inherited diseases may be involved. But in 10-15% of cases, no cause of renal failure can not be determined.
Microalbuminuria: an early sign
Approximately 25% of patients forced to undergo dialysis are diabetics. The kidney damage caused by diabetes is due to a deterioration of the small vessels in the glomeruli. This condition is called diabetic nephropathy. The kidney damage signs must be actively sought in diabetes. One of the most interesting and early markers is microalbuminuria. It is the presence of very low amounts of protein in the urine (30 to 299 mg of albumin per 24 hours).
Strict control of blood pressure
The kidneys play an important role in the regulation of blood pressure because it is they who manage the content of salt and water balance of the body. Kidney disease can therefore lead to the occurrence of hypertension. High blood pressure is harmful to the kidneys and will aggravate kidney failure: he then settled a vicious circle. This is to break this vicious circle we recommend strict control of blood pressure (<130/85 mmHg) in kidney patients. This strict control aims to protect the kidneys but also reduce the risk of cardiovascular complications.
Written by Dr. Peter Mareen
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Hypertension, renal failure, silent killers
Kidney disease are unknown to the public and diagnosed late. They hit a growing number of people in France and worldwide.
Some diseases develop insidiously and induce microscopic lesions, silently, without symptoms for years. Suddenly, when the troubles appear, it is too late. This is the case of high blood pressure that can grow at low noise for decades without being diagnosed or treated. Almost overnight, ESRD appears the person is exhausted, possibly suffering from various disorders, including neurological.
Laboratory tests to diagnose chronic terminal renal failure. At that stage, there is no other choice than dialysis or transplantation. About 30% of people with ESRD have discovered their disease in the context of the emergency.
Monday, on the occasion of the presentation of the World Kidney Day on March 12 (see box), Professor Eric Rondeau (Tenon Hospital, Paris) and the team of experts from the Kidney Foundation have set highlight the major role of hypertension in the genesis of renal failure. They claimed in particular that regular screening of kidney failure in people at risk (hypertension, diabetes, a family history of kidney disease ...) associated with early treatment avoids this kidney disease or delay. In France, 35,000 people need kidney dialysis and 25,000 others are living with a kidney transplant.
With diabetes which is often associated, high blood pressure is a leading cause of kidney failure. In France, 7 million people have high blood pressure, only half following treatment and only 35% of those treated have a properly balanced blood pressure level. Hypertension is known as a cardiovascular risk factor. Its impact on the kidney is largely ignored by the public. There he seems to individual susceptibility to renal hypertension. All hypertensive do not suffer from kidney failure.
Hypertension results in some people with a particular genetic susceptibility, to create a progressive néphroangiosclérose: blood vessels are preferentially affected by sclerosis. Néphroangiosclérose This is more common in the elderly, but is sometimes seen - rarely - before the age of 30 years. "Medical treatment of hypertension, if followed and if it is effective in controlling blood pressure, prevents the occurrence of cerebral and cardiovascular complications, but also chronic complications including inadequate chronic kidney, "says Dr. Eric Rondeau.
All the factors that control blood pressure and reduce the risk of kidney failure. These are drugs. But not only. A weight loss of 5 kg decreases the voltage level, as is the practice of regular physical exercise and reducing alcohol and salt.
Should we make a systematic screening of kidney failure by regular laboratory tests? Probably not, experts say, but we must focus specifically on high-risk populations. Last October, the Kidney Foundation, with the support of laboratories of public and private analyzes, launched a screening week of kidney failure. Over 9000 people participated. Analysis of the results will soon be published.
En France, 35 000 personnes souffrent d'une insuffisance rénale qui nécessite une dialyse.