Ten Facts About Diabetes and Chronic Kidney Disease

Diabetes is the leading cause of kidney failure in the United States. Because a cure for diabetic kidney disease has not yet been found, treatment involves controlling the disorder and slowing its progression to kidney failure. Current research suggests that control of high blood pressure is a key factor in slowing this disease. Strict control of blood sugar levels and reduction of dietary protein intake may also be important. Treatment to prevent diabetic kidney disease should begin early – before kidney damage develops.

1. In the U.S., 24 million people, or about 8 percent of the population, have diabetes. Of these, 18 million are diagnosed and 6 million (nearly one quarter) are undiagnosed.

2. Diabetes is characterized by high levels of blood sugar, resulting from insufficient production of insulin or defects in insulin action in the body. Type 2 diabetes (also called noninsulin-dependent diabetes) is far more common than type 1 (insulin-dependent diabetes), accounting for about 90 to 95 percent of the cases of diabetes. Type 2 diabetes is most common in people over 40, but is increasing among younger people including children and adolescents.

3. Diabetes damages small blood vessels throughout the body, affecting the kidneys as well as other organs and tissues including skin, nerves, muscles, intestines and the heart. Patients with diabetes can develop high blood pressure as well as rapid hardening of the arteries, which can also lead to heart disease and eye disorders.

4. Type 2 diabetes is more prevalent in certain ethnic groups. For example, 11 percent of Hispanic Americans have diabetes. Among American Indians and Alaska Natives receiving care from the Indian Health Service, over 14 percent over the age of 20 have diabetes. Nearly 15 percent of African Americans have diabetes. Asian and Pacific Islanders are also at increased risk for diabetes.

5. Diabetes is the single leading cause of kidney failure in the U.S., accounting for about 44 percent of the people who start treatment for kidney failure each year.

6. The risk factors for type 1 diabetes include autoimmune, genetic and environmental factors. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes (diabetes during pregnancy), impaired glucose tolerance, physical inactivity and race or ethnicity.

7. Gestational diabetes affects about 7% of all pregnant women. This amounts to about 200,000 cases each year in the United States. Gestational diabetes should be treated to prevent complications in the infant. Women who have had gestational diabetes have a 40 to 60 percent chance of developing Type 2 later in life.

8. Research suggests high blood pressure may be the most important predictor for diabetics developing chronic kidney disease. Therefore, the detection and control of high blood pressure is very important for diabetic patients. Specific high blood pressure medicines, such as the angiotensin converting enzyme (ACE) inhibitors and the angiotensin-2 receptor blockers (ARBs), may be the most effective in preventing diabetic kidney disease. About 75 percent of adults with diabetes have blood pressure greater than 130/80 or use medications for high blood pressure.

9. Some of the signs that someone who has diabetes may be developing chronic kidney disease are:

  1. Protein in the urine
  2. High blood pressure
  3. Leg swelling, leg cramps
  4. Increased need to urinate, especially at night
  5. Abnormal blood tests, such as creatinine and estimated GFR tests
  6. Less need for insulin or anti-diabetic pills
  7. Morning sickness, nausea and vomiting
  8. Weakness, pallor and anemia
  9. Itching
  10. Diabetic eye disease

A cure for diabetic kidney disease has not yet been found; the treatment involves controlling the disorder and slowing its progression to irreversible kidney failure. Some of the treatments that may be effective are:

  1. Controlling high blood pressure to less than 130/80 mm/Hg
  2. Controlling blood sugar levels
  3. Reducing dietary protein intake
  4. Avoiding medications that may damage the kidneys
  5. Treating urinary tract infections
  6. Exercise and weight loss (under the supervision of a physician)

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For more information on kidneys and kidney disease, visit www.kidney.org

Sources of Facts and Statistics:

“Diabetes and Kidney Disease” from the National Kidney Foundation

“Kidney Disease of Diabetes” from the National Kidney and Urologic Disease Information Clearinghouse

“National Diabetes Statistics” from the National Kidney and Urologic Disease Information Clearinghouse


December, 2009

The National Kidney Foundation thanks the following sponsors for their support:

Bristol Myers Squibb Novartis