Diabetes and Kidney Disease

More than 17 million Americans have diabetes and require a lifetime of treatment. Diabetes is a complex and very personal disease. The challenges of daily self-management are difficult but the benefits are real.

How Does Diabetes Affect the Body?

In diabetes, high blood sugar levels can damage parts of your body, especially the kidneys, heart, eyes and nerves. High blood pressure and hardening of the arteries also develop from diabetes.

How Does Diabetes Affect the Kidneys?

Diabetes may damage blood vessels in the kidneys, causing kidney damage as well as a decrease in kidney function which can lead to a buildup of waste products in your blood. Other causes of kidney damage are related to several factors, including changes in blood circulation within the kidneys. These changes affect blood pressure and the blood vessels and lead to “spilling” protein in the urine (normally protein should not be present in urine). High blood pressure is also a major factor that puts people with diabetes at risk for kidney disease. Keeping blood pressure at the recommended level can help prevent kidney disease. Diabetic complications can also cause damage to nerves in the body making it hard to empty the bladder. The pressure caused by this may injure the kidney or cause infection.

Diabetes is the Leading Cause of Kidney Disease

Approximately one third of people with diabetes develop kidney disease. Diabetes is the most common cause of kidney failure (stage 5 CKD). At least 50 percent of people with Type 1 diabetes will get kidney damage (early stages of kidney disease). Of that 50 percent, one third will get severe kidney disease (stage 4 CKD) and kidney failure. Certain population groups, such as African Americans, Hispanic Americans and American Indians, have a higher risk of developing kidney failure from Type 2 diabetes than Caucasian Americans.

What is Chronic Kidney Disease (CKD)?

Chronic kidney disease is having kidney damage (the most common sign is "spilling" protein into the urine) and/or having decreased kidney function that may become life threatening over time. In CKD, blood pressure often rises as well. If you have diabetes, high blood pressure or a family member with kidney disease, you should talk to your health care professional about being tested for CKD.

Getting treatment for diabetes and doing all you can to self-manage diabetes may help prevent getting kidney disease. Managing diabetes today is different from the way it was managed 10 years ago. Medication dosing has changed. So have treatment options. The medication a person has been taking for a long time may not be the best medication for them today. Education, screenings and checkups are important and help determine which therapy is most beneficial for each person.

Testing for Kidney Disease

Signs of kidney disease are not always noticed by those who have them. Routine screening for people at risk for kidney disease is important because early detection and treatment of kidney disease may slow its progression to kidney failure.

It is important for people with diabetes to have annual testing for kidney disease. This involves:

1. Urine testing to detect very small amounts of albumin. Albumin is a type of protein. Having a small amount of albumin in the urine is called microalbuminuria. This is a sign that the kidney's filtering units have been damaged. This test is especially important if you are at increased risk for CKD because of diabetes, high blood pressure or a family history of these conditions.

2. GFR (glomerular filtration rate) is the best measure of kidney function. GFR estimates your kidney's filtering ability using the result of a simple blood test for a waste product called creatinine, and other factors like age, gender, and race. GFR is used to determine the stage of kidney disease, and treatment is based on the stage of kidney disease.

If you have diabetes, ask your health care professional to evaluate you for CKD. For more information, contact the National Kidney Foundation at 800.622.9010 or visit www.kidney.org