World Kidney Disease Day is celebrated on 10 March, and few people associate it with endocrinology, even though one of the leading causes of kidney damage is diabetes mellitus along with hypertension. This was said by the head of the First Internal Department at "UMHAT-Plovdiv", Endocrinology, Dr. Stanimira Stancheva-Vasileva.

The kidneys are a paired organ located on the posterior abdominal wall. They are bean-shaped. Besides the known function of purifying the blood, other functions are - participation in the water-electrolyte metabolism, in the alkaline-acid balance, in the hematopoiesis, in the control of blood pressure, in the production of hormones and other biologically active substances, in the metabolism of vitamin D, etc. Diseases affecting the structure or function of the kidneys affect all other organs and systems, and vice versa - other diseases lead to changes in them due to the fact that our organism functions as a whole. The leading diseases proven to damage the kidneys are diabetes mellitus and arterial hypertension. The prevalence of kidney damage is robust as 10% of the world's population has established chronic kidney suffering. In diabetics, however, between one and three people develop the problem, or 40% of diabetics have kidney disease.

Risk factors for kidney problem in diabetes mellitus are poor metabolic control, long duration of diabetes, unhealthy diet with salt abuse, reduced water intake, overconsumption of protein foods and alcohol, smoking, obesity, dyslipidaemia, elevated uric acid level, metabolic syndrome or concomitant cardiovascular disease, untreated urinary tract infections, prolonged use of analgesics, NSAIDs, certain types of antibiotics and other groups of medications.

The presence of renal suffering is established by testing venous blood for creatinine with subsequent calculation of glomerular filtration rate according to a defined formula. In addition, a urinalysis is performed -microalbuminuria, albumin in 24-hour urine, albumin-creatinine ratio in a single portion of urine. Renal ultrasonography is also needed, as well as additional specific tests - laboratory - blood-sugar profile, HbA1c, urea, uric acid, potassium, or instrumental tests.

Why should the kidneys be monitored and treated? Because it reduces the risk of cardiovascular or renal events, reduces overall mortality, prevents or delays the time to reach terminal renal failure requiring dialysis treatment, preserves work capacity and quality of life, and increases survival for these patients.

As trivial as the recommendations sound, patients are first advised to quit smoking, increase physical activity, stick to a diet and fight excess weight, the chief said.

She said controlling existing chronic diseases was very important. This includes systematic monitoring of blood glucose and glycated haemoglobin for diabetic patients, regular measurement of PP, avoiding unjustified intake of medicines, adherence to therapy prescribed by a specialist, regular attendance for check-ups, conducting the prescribed tests, etc.

The second group of recommendations are for us physicians who should avoid therapeutic inertia, tailor the type of antidiabetic therapy to the results of current renal indicators, promptly refer to a dialysis center, devote additional time to increase our knowledge and qualifications in this area, to educate and re-educate patients on the problem, to apply an individual approach to each patient and collaboration between colleagues from different fields - endocrinologists, cardiologists, nephrologists, doctors in dialysis centres, family doctors. I BGNES