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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Saturday, January 16, 2016

PRE-DIABETES HARMS KIDNEY HEALTH

Diabetes is known to be the leading cause of kidney disease and kidney failure.  Excess blood sugar is passed through the kidney, which, overtime, causes damage.  Now, new research finds that even the modestly elevated blood sugar levels of pre-diabetes impact kidney health.  Pre-diabetes affects more than 35% of American adults -- and an estimated 90% of those do not know they have the disease. About half of those with pre-diabetes develop diabetes within 10 years.

The study tracked the kidney function of 595 individuals with pre-diabetes and 729 healthy control subjects over an average of 5.6 years.  Participants ranged in age from 50-62 years.  The investigators found that patients with pre-diabetes had early signs of kidney damage, including high levels of the protein albumin in their urine.

To make matters worse, another interesting recent investigation found that slight reductions in kidney function are an independent contributor to heart disease.  Since persons with kidney disease commonly have other heart health risk factors, such as high blood pressure and diabetes, the direct effect of diminishing kidney function on the heart has been uncertain.  But, this study focused on kidney donors who must not have risk factors for kidney disease.  Researchers tracked kidney and heart health before and over the following year after nephrectomy (kidney removal surgery).  When donors lose a kidney, their kidney function initially drops and then over the following years as the remaining kidney adapts, filtration rates gradually recover.  Researchers found that at 1-year out after their nephrectomy, donors' hearts revealed early signs of damage.   They noted an increased left ventricle size, a strong predictor of elevated heart disease risk.  So, while these results are not of great concern to kidney donors who are a healthy group, they underscore the significance to heart health of even modest losses in kidney function such as that seen in pre-diabetics.

What to do:  These findings illustrate the importance of catching pre-diabetes early and making lifestyle changes that can return blood sugar to healthy levels and prevent diabetes.  The American Diabetes Association defines pre-diabetes as having a fasting blood sugar of 100-125 mg/dL and/or a hemoglobin A1c of 5.7-6.4%.   Research shows that moderate cardiovascular exercise such as brisk walking for 30 minutes five times per week and a 5-7% reduction in bodyweight can prevent or delay diabetes in those with pre-diabetes.  If you have excess weight or other risk factors for diabetes, make sure your provider is checking your hemoglobin A1c blood level which often indicates pre-diabetes before fasting blood sugar levels become elevated.

Sources:
Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.  Available online at:  http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html

Melsom T, Schei J, Stefansson VTJ et al.  Prediabetes and risk of glomerular hyperfiltration and albuminuria in the general nondiabetic population: A prospective cohort study.  American Journal of Kidney Diseases.  Published online ahead of print December 29, 2015DOI: http://dx.doi.org/10.1053/j.ajkd.2015.10.025

Moody WE, Ferro CJ, Edwards NC, et al. Cardiovascular effects of unilateral nephrectomy in living kidney donors. Hypertension 2016;67:368-377; DOI: 10.1161/hypertensionaha.115.06608.

Adapted from articles available at:
http://www.newsroom.heart.org/news/even-small-reductions-in-kidney-function-may-damage-heart-blood-vessels
https://www.nlm.nih.gov/medlineplus/news/fullstory_156445.html http://www.sciencedaily.com/releases/2016/01/160111162754.htm

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