Stroke is a serious ailment because it is the third leading cause of death, after heart disease and cancer. Diabetic kidney disease or diabetic nephropathy is a form of chronic kidney. Patients with diabetic kidney disease have exceptionally high rates of cardiovascular morbidity and mortality. Due to poor control of the mechanisms underlying the strong association between diabetic kidney disease and various forms of cardiovascular disease, deaths due to strokes have increased. As per a report published by NCBI journal, the risk of stroke is 5-30 times higher in patients with chronic kidney disease (CKD), especially in those on dialysis.
Diabetic kidney disease is a type of chronic kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease in many countries including India. According to a report about 1 out of 3 adults with diabetes have kidney disease. In India, stroke cases are on rise due to diabetes, hypertension, smoking, obesity and unhealthy lifestyle. A recent scientific paper published in the Lancet Global Health shows that in 2019, stroke caused 7 lakh deaths in India. This trend is alarming in the wake of COVID-19 pandemic and could further lead to the country’s disease burden.
“Chronic kidney disease patients are at increased risk of stroke, especially in presence of type 2 diabetes. It has been found to be a big risk factor as due to type 2 diabetes, there is impairment in the way the body regulates and uses sugar (glucose) as a fuel. This long-term condition results in too much sugar circulating in the bloodstream. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous, and immune systems and stroke is one such complication in kidney patients with diabetes. The risk of cardiovascular diseases, including stroke in patients with end-stage renal disease (ESRD) is 5–30 times greater than that in the general population,” says Dr Deepak Dewan, MD, DM (Nephrology), Director Renal Sciences, Regency Superspecialty Hospital.
Chronic kidney disease (CKD) is an independent risk factor for stroke, including both hemorrhagic and ischemic subtypes. Most people with early diabetic kidney disease do not have any symptoms. The only way to know if one has diabetic kidney disease is to get examined by a doctor and get himself/herself investigates. In middle income countries like India, high prevalence of infectious causes of kidney disease as well as rising rates of hypertension and particularly of untreated diabetes are some the factors behind stroke in patients with chronic kidney disease.
Stroke risk due to diabetic kidney disease can be reduced by correcting reversible risk factors. This includes treating hypertension, stopping smoking, controlling diabetes, cardiac disease, regular exercise, adapting a healthy diet and preventing excessive use of alcohol. However, there are some nonmodifiable risk factors as well, these include age, male gender, family history of stroke, and nonwhite race.