Slight Blood Sugar Elevation Linked To Kidney Damage -

Kidney diseases are an enigma. A single, conclusive cause for any individual patient’s kidney disease is usually impossible to isolate and identify. However, it’s established that diabetes and a high blood sugar level directly contribute to kidney disease. Those with higher than normal blood sugar levels are more likely than the average person to have too much albumin (a protein) in the urine and to have problems with abnormal blood filtration.

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Around the world in the 21st century, more than ten percent of all adults have diabetes, which develops when the body can’t properly use or make enough insulin to convert sugar into energy. Diabetes is often linked to kidney disease, but now, researchers in Norway have determined that even people with borderline blood sugar levels – high but not diabetic – have an increased risk for kidney disease.

The relationship between chronic kidney disease and diabetes is well-established, but doctors disagree about how much sugar in the blood might pose a kidney disease risk to people who have not developed chronic kidney disease. There’s also disagreement among the experts regarding how to diagnose and treat patients with mildly high blood glucose levels and whether it is appropriate to refer to this condition as “pre-diabetic.”

WHO WERE THE SUBJECTS OF THE NORWEGIAN RESEARCH?

Norwegian researchers assessed the blood sugar levels and indications of kidney damage in 1,261 people ages 50 to 62 who didn’t have diabetes. Researchers determined blood sugar levels by measuring the blood glucose in patients who were fasting and by measuring blood levels of hemoglobin A1c. The hemoglobin A1c test estimates the average blood sugar level over several months based on the percentage of hemoglobin – the protein in red blood cells that carries oxygen – coated with sugar.

At the beginning of the research, according to lead researcher Dr. Toralf Melsom of the University of North Norway, 595 people had a slightly high blood sugar level based on U.S. guidelines, which are fairly stringent. European guidelines require more sugar before glucose levels are considered elevated, so under those criteria, only 169 of the study participants had a “slightly high” blood sugar level.

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After a five-year follow-up period, participants with slightly high blood sugar – under either set of guidelines – were more likely to have kidneys working harder to filter their blood, a condition called hyperfiltration. Those individuals were also more likely to have elevated levels of albumin in the urine, indicating early kidney damage. Those with slightly higher blood sugar under the European guidelines were 95 percent more apt to have hyperfiltration and 83 percent more likely to have high albumin levels in the urine.

WHAT DIFFICULTIES DID THE NORWEGIAN RESEARCHERS FACE?

Writing in the American Journal of Kidney Diseases, the Norwegian researchers admitted that only middle-aged white subjects participated in the study, so the results may differ significantly for patients in other populations. Another twist in the research is the difficulty in defining hyperfiltration. That’s because the nephrons, the kidney’s waste-processing units, vary by age and gender. On the positive side, the study reaffirms the need for doctors to focus on patients with slightly elevated blood sugar levels.

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Dr. Laura Rosella, a public health researcher at the University of Toronto, says those patients should focus on lifestyle changes that include a better diet, regular exercise, and for some, weight loss. She says, “If someone adopts the necessary changes that would prevent the onset of diabetes, it is likely to protect against the progression to kidney disease as well – just like it will prevent cardiovascular disease and many cancers.”

HOW CAN YOU MAINTAIN A HEALTHY BLOOD SUGAR LEVEL?

The World Health Organization says that around the world in 2012, over 2.2 million deaths could be attributed to high blood sugar in people who did not have diabetes. Maintaining a healthy blood sugar level one of the best strategies for avoiding chronic kidney disease. Here are some basic diet and exercise suggestions to help you get started:

  • Limit the consumption of foods that cause blood sugar levels to spike. Reduce your intake of carbohydrates and eat more fruits, vegetables, and lean protein. According to the Joslin Diabetes Center in Boston, an average adult should consume between 20 and 35 grams of fiber each day.
  • Drink eight 8-ounce glasses of water or some other sugar-free liquids every day. Limit consumption of drinks with caffeine. Put some pizazz in your drinking water by infusing it with lemon or fresh fruit.
  • Put some pizazz in your diet, too. Substitute unsweetened applesauce for butter or oil in cookie and cake recipes. You’ll lower your calorie intake and increase your vitamins and minerals. In creamy recipes like vegetable dips, replace mayonnaise or sour cream with Greek yogurt to reduce your fat intake. Substitute white flour with whole-wheat flour and whole milk with skim milk.
  • Take advantage of the abundant online resources for making a healthy diet a routine part of your lifestyle. The Department of Agriculture’s ChooseMyPlate.gov site provides quick and easy reference tools on healthy eating. Kidney disease patients will also want to visit MySpiceItUp.ca, a site that provides kidney-friendly recipes approved by a team of licensed renal dietitians.

According to a National Kidney Foundation estimate, approximately 26 million people in the United States have chronic kidney disease and another 20 million are at risk. That creates abundant opportunities for medical errors and medical malpractice. While general practitioners may not be expected to have a kidney specialist’s knowledge, they are supposed to know when a patient should be seen by a specialist. If you or someone you love has been misdiagnosed, improperly treated, or injured by medical malpractice related to kidney disease, discuss your legal rights and options at once with an experienced medical malpractice attorney.

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Kidney disease can be accurately diagnosed only with a renal biopsy. If you are in a high risk group for kidney disease – that is, if you’re more than 60 years old or if you have a history of kidney disease in your family – have your doctor examine you for kidney disease. If your own physician finds a high blood sugar level or high albumin levels in your urine, he or she should immediately refer you to a nephrologist.

If a doctor fails to diagnose or treat your kidney disease, speak at once with an experienced medical malpractice attorney. An accurate and early diagnosis can often reduce and sometimes even reverse the consequences of kidney disease, but a misdiagnosis can exacerbate your medical condition, delay your treatment, and cause your health to deteriorate. When you’re a kidney disease patient, guarding your health is imperative, and sometimes, protecting your legal rights is just as important.

By: Jed Kurzban

Medical malpractice attorney Jed Kurzban graduated from the University of Alabama in 1992 and earned his Juris Doctor from the University of Miami School of Law in 1995. He is a member of the Dade County Bar Association, the Florida Bar Association, the American Association for Justice, the Academy of Florida Trial Lawyers, and the American Bar Association. Mr. Kurzban is happily married and the father of two.