Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease Kidney disease or kidney damage often occurs over time in people with diabetes. This type of kidney disease is called diabetic nephropathy. The urinary system is made up of the kidneys, ureters, urethra and bladder. Uncontrolled diabetes causes damage to many tissues of the body including the kidneys. Kidney damage caused by diabetes most often involves thickening and hardening of the internal kidney structures. Strict blood glucose control may delay the progression of kidney disease in type 1 and type 2 diabetics.
During diabetic nephropathy the kidney becomes damaged and more protein than normal collects in the urine. As the disease progresses, more of the kidney is destroyed. Over time, the
kidneys ability to function starts to decline, which may eventually lead to chronic kidney failure. Each kidney is made of hundreds of thousands of small units called nephrons. These structures filter your blood, help remove waste from the body, and control fluid balance. In people with
diabetes, the nephrons slowly thicken and become scarred over time. The nephrons begin to leak, and protein (albumin) passes into the urine. This damage can happen years before any symptoms of kidney disease begin. Kidney damage is more likely if you:
Diabetes is on the rise worldwide, and is a serious, lifelong disease that can lead to heart disease, stroke, and lasting nerve, eye and foot problems. Let's talk about diabetes and the difference between the three types of diabetes. So, what exactly is diabetes and where does it come from? An organ in your body called the pancreas produces insulin, a hormone that controls the levels of your blood sugar. When you have too little insulin in your body, or when insulin doesn't work right in your body, you can have diabetes, the condition where you have abnormally high glucose or sugar levels in your blood. Normally when you eat food, glucose enters your bloodstream. Glucose is your body's source of fuel. Your pancreas makes insulin to move glucose from your bloodstream into muscle, fat, and liver cells, where your body turns it into energy. People with diabetes have too much blood sugar because their body cannot move glucose into fat, liver, and muscle cells to be changed into and stored for energy. There are three major types of diabetes. Type 1 diabetes happens when the body makes little or no insulin. It usually is diagnosed in children, teens, or young adults. But about 80% of people with diabetes have what's called Type 2 diabetes. This disease often occurs in middle adulthood, but young adults, teens, and now even children are now being diagnosed with it linked to high obesity rates. In Type 2 diabetes, your fat, liver, and muscle cells do not respond to insulin appropriately. Another type of diabetes is called gestational diabetes. It's when high blood sugar develops during pregnancy in a woman who had not had diabetes beforehand. Gestational diabetes usually goes away after the baby is born. But, still pay attention. These women are at a higher risk of type 2 diabetes over the next 5 years without a change in lifestyle. If you doctor suspects you have diabetes, you will probably have a hemoglobin A1c test. This is an average of your blood sugar levels over 3 months. You have pre-diabetes if your A1c is 5.7% to 6.4%. Anything at 6.5% or higher indicates you have diabetes. Type 2 diabetes is a wake up call to focus on diet and exercise to try to control your blood sugar and prevent problems. If you do not control your blood sugar, you could develop eye problems, have problems with sores and infections in your feet, have high blood pressure and cholesterol problems, and have kidney, heart, and problems with other essential organs. People with Type 1 diabetes need to take insulin every day, usually injected under the skin using a needle. Some people may be able to use a pump that delivers insulin to their body all the time. People with Type 2 diabetes may be able to manage their blood sugar through diet and exercise. But if not, they will need to take one or more drugs to lower their blood sugar levels. The good news is, people with any type of diabetes, who maintain good control over their blood sugar, cholesterol, and blood pressure, have a lower risk of kidney disease, eye disease, nervous system problems, heart attack, and stroke, and can live, a long and healthy life. SymptomsOften, there are no symptoms as the kidney damage starts and slowly gets worse. Kidney damage can begin 5 to 10 years before symptoms start. People who have more severe and long-term (chronic) kidney disease may have symptoms such as:
Exams and TestsYour health care provider will order tests to detect signs of kidney problems. A urine test looks for a protein, called albumin, leaking into the urine.
Your provider will also check your blood pressure. High blood pressure damages your kidneys, and blood pressure is harder to control when you have kidney damage. A kidney biopsy may be ordered to confirm the diagnosis or look for other causes of kidney damage. If you have diabetes, your provider will also check your kidneys by using the following blood tests every year:
TreatmentWhen kidney damage is caught in its early stages, it can be slowed with treatment. Once larger amounts of protein appear in the urine, kidney damage will slowly get worse. Follow your provider's advice to keep your condition from getting worse. CONTROL YOUR BLOOD PRESSURE Keeping your blood pressure under control (below 130/80 mm Hg) is one of the best ways to slow kidney damage.
CONTROL YOUR BLOOD SUGAR LEVEL You can also slow kidney damage by controlling your blood sugar level through:
OTHER WAYS TO PROTECT YOUR KIDNEYS
Support GroupsMany resources can help you understand more about diabetes. You can also learn ways to manage your kidney disease. Outlook (Prognosis)Diabetic kidney disease is a major cause of sickness and death in people with diabetes. It can lead to the need for dialysis or a kidney transplant. When to Contact a Medical ProfessionalCall your provider if you have diabetes and you have not had a urine test to check for protein. ReferencesAmerican Diabetes Association Professional Practice Committee. 12. Retinopathy, Neuropathy, and Foot Care: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S185-S194. PMID: 34964887 pubmed.ncbi.nlm.nih.gov/34964887/. Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37. Tong LL, Adler S, Wanner C. Prevention and treatment of diabetic kidney disease. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 31. Version InfoLast reviewed on: 2/1/2022 Reviewed by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What are the signs of kidney failure in diabetics?Symptoms. Worsening blood pressure control.. Protein in the urine.. Swelling of feet, ankles, hands or eyes.. Increased need to urinate.. Reduced need for insulin or diabetes medicine.. Confusion or difficulty concentrating.. Shortness of breath.. Loss of appetite.. Can kidneys affect blood sugar levels?In hyperglycemia, the kidneys may play an exacerbating role by reabsorbing excess glucose, ultimately contributing to chronic hyperglycemia, and subsequently to pancreatic β-cell failure, insulin resistance, and decreased glucose uptake.
Does high glucose mean kidney failure?A high level of sugar in your blood can cause problems in many parts of your body, including your heart, kidneys, eyes, and brain. Over time, this can lead to kidney disease and kidney failure.
What are the 3 early warning signs of kidney disease?Here are three signs that could indicate that you are beginning to experience a decline in kidney function.. Dizziness and Fatigue. One of the first possible signs of weakening kidneys is the experience of overall weakness in yourself and your overall health. ... . Swelling (Edema) ... . Changes in urination.. |