The Top 5 Questions about Diabetes and Chronic Kidney Disease

Recent reports from the Centers for Disease Control and Prevention (CDC) estimate that one in three people in the United States will have diabetes by the year 2050. The number stands now at one in ten. Diabetes is the leading cause of kidney failure, responsible for nearly half of the new cases last year. Yet proper management and treatment of diabetes can help prevent the onset of kidney disease. This month, the National Kidney Foundation answers the top 5 questions about diabetes and chronic kidney disease.

1. What is diabetes and who's at risk?

Diabetes is a serious disease. It occurs when your body does not make enough insulin or cannot use the insulin it makes. Insulin is a hormone that controls the level of sugar (called glucose) in your blood. A high blood sugar level can cause problems in many parts of your body.

There are two types of diabetes. In Type 1 diabetes your body does not make insulin. It usually starts when you are a child or young adult, but it can occur at any age. It is treated by taking daily insulin shots or using an insulin pump and by following a special meal plan. About 5 to 10 percent of cases of diabetes are type 1.

In type 2 diabetes your body makes some insulin but cannot use it properly. Type 2 is partially preventable and is typically brought on by poor diet and lack of exercise. Very often heredity plays a part, as well. The disease usually occurs in people over 40, although it is becoming more common in younger people, and is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans.

2. How can diabetes damage the kidneys?

The filtering units of the kidney are filled with tiny blood vessels. Over time, high sugar levels in the blood can cause these vessels to become scarred and clogged. Without enough blood, the kidneys become damaged and albumin (a type of protein) passes through these filters and ends up in the urine where it should not be.

Diabetes can also cause damage to the nerves in your body. Nerves carry messages between your brain and all other parts of your body, including your bladder. They let your brain know when your bladder is full. But if the nerves of the bladder are damaged, you may not be able to feel when your bladder is full. The pressure from a full bladder can damage your kidneys. If urine stays in your bladder for a long time, you may get a urinary tract infection (http://www.kidney.org/kidneyDisease/uti/index.html) through the buildup of bacteria.

3. What can diabetics do to prevent or delay chronic kidney disease (CKD)?

The best way protect the kidneys from being damaged is by controlling blood sugar. This is usually done with diet, exercise, and, if needed, insulin shots or hypoglycemic pills. Daily monitoring of your blood sugar should be done at home, as well as regular A1C tests performed by your doctor which tell you average blood sugar levels over 6 to 8 weeks. Diabetics should also monitor their blood pressure and cholesterol levels.

4. What are the signs of diabetic kidney disease?

Often kidney disease develops without noticeable symptoms, however it can be diagnosed with 3 simple tests blood pressure, urinalysis and GFR. You can receive these tests at your doctor's office or at a National Kidney Foundation KEEP Screening .

Some symptoms that may occur include weight gain, ankle swelling, nausea, vomiting, loss of appetite, weakness, fatigue, itching and muscle cramps. You may also find you need less insulin because diseased kidneys cause less breakdown of insulin.

5. What is kidney failure and how is it treated?

Kidney failure means your kidneys have stopped working well enough to keep you alive. Harmful wastes and fluid begin to build up in your body, blood pressure may rise and your body cannot make enough red blood cells.

When this happens, you need treatment to replace the work of your failed kidneys. There is no cure for kidney failure. A person with kidney failure needs treatment to live. Three types of treatment can be used if your kidneys have failed: hemodialysis, peritoneal dialysis or kidney transplantation .

Your health care team will help you choose the best treatment for you based on your general health, lifestyle and treatment preference. Your decision does not need to be a final decision. Many people have used each one of these treatments at different times.