• Diabetes

Don’t Let Diabetic Kidney Disease Sneak Up on You

Like a ninja in the night, diabetic kidney disease is silent. By the time you’re diagnosed, the damage has been done. Treatment can help slow disease progression, but prevention is a better way to spend your energy and your life.  

Diabetic kidney disease is also known as chronic kidney disease and diabetic nephropathy. About one in four adults with diabetes has kidney disease.

Maintaining control of your diabetes is the best way to lower your risk of developing severe kidney disease. 

How Does Diabetes Cause Kidney Disease?

Your kidneys filter and clean about 50 gallons of blood every day, removing waste products your body doesn’t need and releasing them through urine.

High blood sugar levels can overwork and damage your kidneys. When your kidneys don’t filter blood as they should, waste products build up in your body. Increased blood sugar can cause the tiny blood vessels in the kidney’s filtering units to narrow and clog. This prevents adequate blood flow and damages the kidneys so they can’t remove the waste from the blood. Your risk of kidney damage increases with the length of time you’ve had diabetes.

About 30 percent of people with Type 1 diabetes and 10 to 40 percent with Type 2 diabetes eventually suffer from kidney failure. 

About one in four adults with diabetes has kidney disease.

The Easy Test that Spots Early Kidney Damage

You may not have any symptoms of kidney disease in its early stages. Kidney disease produces no physical symptoms until almost all function is gone. However, early kidney damage can be diagnosed, preventing kidney disease from worsening.

The first sign of early kidney damage is a condition known as microalbuminuria. This is caused when your malfunctioning kidneys mistakenly leak small amounts of a protein called albumin into your urine.

The microalbuminuria test measures the amount of albumin that has leaked into your urine. Little or no albumin in the urine means your kidneys are normal. A moderate amount means early kidney damage, or first stage chronic kidney disease. A large amount means more severe kidney disease.

Keep in touch with your health care provider to stay current on testing. Your doctor also may do a blood test to see how well your kidneys are filtering.

The American Diabetes Association recommends an annual microalbuminuria test if you have Type 2 diabetes. For Type 1 diabetes, you should be tested once a year if you are older than age 10 or have had diabetes for five years or longer. If you take certain medicines, have high blood pressure or have more albumin in your urine than is normal, you may need to be tested more often.

How to Prevent Diabetic Kidney Disease

Research has shown that tight blood sugar control reduces the risk of microalbuminuria by one third. In people who already had microalbuminuria, the risk of progressing to severe kidney disease was cut in half.

These strategies also can protect your kidneys and prevent or delay kidney damage:

• Don’t smoke
• Follow your diabetes meal plan and a heart-healthy diet.
• Limit salt and sodium
• Exercise
• Stay at or get to a healthy weight
• Get enough sleep (seven to eight hours each night)
• Manage your blood pressure through prescribed medication (high blood pressure is another major cause of kidney disease)
• Manage stress (long-term stress can raise your blood sugar and blood pressure)

Work with your health care provider to reach your blood sugar and blood pressure goals.  Blood pressure has a dramatic effect on the rate at which diabetic kidney disease progresses. Even if you have just a small amount of protein in your urine, discuss with your doctor if it’s time to make an appointment with a kidney doctor, called a nephrologist. The earlier treatment begins, the better.

Some medicines that lower blood pressure can also help protect your kidneys and slow kidney damage.

How Is Diabetic Kidney Disease Treated?

Treatment is individualized for each person and will depend on your overall health, age and disease severity. Kidney disease can take many years to progress to the most severe stage.

The same strategies that help prevent kidney disease also can aid in treatment, along with medication to slow disease progression.

Early diagnosis and treatment of diabetic kidney disease can reduce your risk for end-stage renal disease, or kidney failure. At this disease stage, you will need dialysis to cleanse your blood. Eventually, kidney transplant may also be a consideration.

Source: U.S. Department of Health and Human Services, National Institute of Diabetes and Digestive and Kidney Diseases; National Kidney Foundation; American Diabetes Association