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Kidney Disease

Diabetes and the Development of Kidney Disease

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Updated November 29, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Kidney Disease

Your kidneys have a finely tuned filtering system that can break down when your blood glucose is consistently high.

National Kidney Foundation

If you are like most people, you don't think much about your kidneys. They are tireless workers doing their important and vital work behind the scenes. But diabetes can cause problems with your kidneys that can lead to serious complications.

How Do the Kidneys Work?

The primary job of your kidneys is to filter out wastes in your blood. These waste products are the natural result of digesting proteins from the food you eat. When the kidneys are able to do their job, these waste products are eliminated in your urine, which keeps the blood relatively free of these harmful wastes. This is how healthy kidneys are supposed to work.

What is Kidney Disease?

The kidneys have a very efficient filtering system for these waste products, which is made up of tiny blood vessels. Kidney disease causes these filters to break down. If the filtering system continues to decline in its ability to rid the body of these waste products, waste begins to build up in the blood. This is a sign that the kidneys are failing and may eventually stop working altogether. If this happens, dialysis is necessary to remove these wastes from the blood.

The Role Diabetes Plays in Kidney Disease

High blood sugar forces the kidneys to work extra hard and contributes to the breakdown of the kidneys' filtering system. In addition to high blood sugar, high blood pressure, which is also a common health problem in those with diabetes, further compromises the function of the kidneys. The combination of continuously high blood sugar and high blood pressure puts anyone with diabetes at significant risk for eventually having kidney disease.

Symptoms of Early Kidney Disease

Unfortunately, there might not be many noticeable symptoms in the early stage of kidney disease. One of the most effective ways to determine whether the kidneys are being damaged is to measure the amount of protein in your urine. When the kidneys are working properly, they are able to filter out the waste products but keep vital nutrients, like protein, in the body. If measurable amounts of protein are detected in the urine, it indicates that the filtering system of your kidneys is starting to break down. This is referred to as microalbuminuria or proteinuria.

This is why it is important to be tested at least once a year for measurable amounts of protein in your urine. Without this test, you may be experiencing damage to your kidneys without knowing it.

If larger amounts of protein are found in the urine, it is called macroalbuminuria. As the term macro implies, it indicates that more significant damage to the kidneys has occurred because higher amounts of protein are getting through the kidneys' filtering system. When a person is diagnosed with kidney disease and has macroalbuminuria, it is usually a sign that the kidneys are already starting to fail and will likely lead to end-stage renal disease (ESRD) over time.

When symptoms are present and noticeable, they include:

  • fluid buildup
  • loss of sleep
  • poor appetite
  • upset stomach
  • weakness
  • difficulty concentrating

Preventing Kidney Disease

Kidney disease that is caused by consistently high blood sugar can be prevented if you manage your blood glucose by keeping it in your target range most of the time. Keeping your blood pressure under control is also important for the prevention of kidney disease. Practical ways to manage your blood pressure include:

  • losing weight
  • eating less salt
  • avoiding alcohol and tobacco
  • getting regular exercise

Treating Kidney Disease

If kidney disease is diagnosed early, treatment can slow the progression of the disease. One common treatment for kidney disease is a low-protein diet. Protein tends to increase the workload of the kidneys. By reducing the amount of protein you eat, you can also lessen the kidneys' workload. There are also medications available to lower blood pressure.

If kidney failure occurs, dialysis is necessary to remove the wastes that will inevitably build up in the blood. The only other option would be to get a kidney transplant.

Source:

American Diabetes Association. "Kidney Disease (Nephropathy).”

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