Inside them are millions of tiny blood vessels that act as filters. Their job is to remove waste products from the blood. Sometimes this filtering system breaks down.
Diabetes can damage the kidneys and cause them to fail. Failing kidneys lose their ability to filter out waste products, resulting in kidney disease. When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels capillaries with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine.
Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood. Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria. When kidney disease is diagnosed early, during microalbuminuria, several treatments may keep kidney disease from getting worse.
Having larger amounts of protein in the urine is called macroalbuminuria. When kidney disease is caught later during macroalbuminuria, end-stage renal disease, or ESRD, usually follows.
Kidney failure means the kidneys are no longer able to remove waste and maintain the level of fluid and salts that the body needs. One cause of kidney failure is diabetes mellitus, a condition characterised by high blood glucose sugar levels.
Over time, the high levels of sugar in the blood damage the millions of tiny filtering units within each kidney. This eventually leads to kidney failure. Around 20 to 30 per cent of people with diabetes develop kidney disease diabetic nephropathy , although not all of these will progress to kidney failure.
A person with diabetes is susceptible to nephropathy whether they use insulin or not. The risk is related to the length of time the person has diabetes. There is no cure for diabetic nephropathy, and treatment is lifelong.
Another name for the condition is diabetic glomerulosclerosis. People with diabetes are also at risk of other kidney problems, including narrowing of the arteries to the kidneys, called renal artery stenosis or renovascular disease.
For people with diabetes, kidney problems are usually picked up during a check-up by their doctor. Occasionally, a person can have type 2 diabetes without knowing it. This means their unchecked high blood sugar levels may be slowly damaging their kidneys.
At first, the only sign is high protein levels in the urine, but this has no symptoms. It may be years before the kidneys are damaged severely enough to cause symptoms. Some of the symptoms may include:. The human body has two kidneys, one on either side of the spine beneath the lower ribs. Inside each kidney are about one million tiny units called nephrons. Each nephron consists of a small filter glomerulus attached to a tubule. Water that contains waste is separated from the blood by the filters and directed into the tubules.
Much of the water is returned to the blood by the tubules, while the wastes are concentrated into urine. All people with diabetes have a risk of developing diabetic kidney disease. However, a large research trial showed that there are certain factors that increase the risk of developing this condition. These are:. This means that having a good control of your blood glucose level, keeping your weight in check and treating high blood pressure will reduce your risk of developing diabetic kidney disease.
If you have early diabetic kidney disease microalbuminuria , the risk that the disease will become worse is increased with:. In people with proteinuria described above , end-stage kidney failure develops in approximately 1 in 12 people after 10 years. If this occurs then you would need kidney dialysis or a kidney transplant. All people with diabetes have an increased risk of developing cardiovascular diseases, such as heart disease, stroke and peripheral arterial disease.
If you have diabetes and diabetic kidney disease, your risk of developing cardiovascular diseases is increased further. The worse the kidney disease, the further increased the risk. This is why reducing any other cardiovascular risk factors is so important if you have diabetic kidney disease see below. Kidney disease has a tendency to increase blood pressure. In addition, increased blood pressure has a tendency to make kidney disease worse.
Treatment of high blood pressure is one of the main treatments of diabetic kidney disease. There are several types and brands of this type of medication.
ACE inhibitors work by reducing the amount of a chemical called angiotensin II that you make in your bloodstream. This chemical tends to narrow constrict blood vessels. Therefore, less of this chemical causes the blood vessels to relax and widen and so the pressure of blood within the blood vessels is reduced. ACE inhibitors are medicines that are often used to treat high blood pressure.
However, the way they work also seems to have a protective effect on the kidneys and heart. This means that they help to prevent or delay the progression of the kidney disease. The ones available in the UK are: azilsartan , candesartan , eprosartan , irbesartan , losartan , olmesartan , telmisartan and valsartan.
For example, some people taking an ACE inhibitor develop a persistent cough. Good control of your blood sugar glucose level will help to delay the progression of the kidney disease and to reduce your risk of developing associated cardiovascular diseases, such as heart disease and stroke.
Strict blood pressure control is likely to reduce the risk of developing cardiovascular diseases and prevent or delay the progression of kidney disease. These medicines lower blood pressure. Certain medicines can affect the kidneys as a side-effect which can make diabetic kidney disease worse.
For example, you should not take anti-inflammatory medicines unless advised to by a doctor. You may also need to adjust the dose of certain medicines that you may take if your kidney disease becomes worse. When diabetes is not well controlled, the sugar level in your blood goes up. This is called hyperglycemia. Hyperglycemia high blood sugar can cause damage to many parts of your body, especially the kidneys, heart, blood vessels, eyes, feet, nerves.
Most people with early kidney damage do not have symptoms. The best way to find early kidney damage is to have a urine test once a year. This test checks for very small amounts of protein in the urine called albuminuria.
It helps show kidney damage at an early stage in people with diabetes. Not everyone with kidney disease gets kidney failure. With the right treatment, you can prevent kidney disease from getting worse. Your healthcare provider will create a treatment plan for you. You may also need to see a kidney doctor called a "nephrologist". A dietitian may be helpful too. The following things can help your kidneys work better and last longer:.
The National Kidney Foundation has free booklets that provide more information about diabetes and kidney disease. Call the national toll-free number You can see these and other titles at www. If you would like more information, please contact us. Skip to main content.
Diabetes and Kidney Disease Stages
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