Diabetes is a disease that affects many parts of your body. If you have diabetes, your body goes not make enough insulin or cannot use insulin correctly. Insulin is a hormone, produced by the pancreas, which regulates the amount of glucose (sugar) in the blood. High blood sugar levels, especially consistent ones, can do serious damage to your body, especially essential organs like the liver and kidneys. In fact, most diabetes patients who develop kidney disease do not have kidney irregularities or symptoms until their kidneys lose at least 75 percent of their normal function.
Kidneys are located on either side of the spine, just below the rib cage. They filter waste and fluid from the body through a serious of small filtering units located inside each kidney that essentially clean the fluid, send any needed minerals back to the bloodstream, and send waste to the bladder. The kidneys are an essential organ because they keep the composition of the blood stable—removing any toxins and separating needed materials from fluid.
Diabetes (both Type 1 and Type 2 diabetes) damages small blood vessels in the body. When these blood vessels are injured, especially the ones in kidneys, the kidneys cannot perform the essential filtering function that they are meant for. The kidneys will begin to clean the blood less efficiently, and the body will retain more salt and water. Protein may be found in urine due to decreased kidney function, and waste materials may build up in the blood. Diabetes can also cause nerve damage to the body — most are familiar with blood circulation issues as a symptom of nerve damage, but nerves are everywhere in our bodies—including our bladder. If a bladder cannot signal the brain that it is full, or if those signals are blocked or not being read, the pressure resulting from a full bladder can back up and damage the kidneys. Additionally, infections can occur from urine that has high sugar levels in it—bacteria grow more rapidly there. Diabetes is the most common cause of kidney failure in the United States.
Kidney failure due to diabetes is a common condition that develops from both Type 1 and Type 2 diabetes. Since most patients do not know that the kidneys are failing until almost all regular function is gone, it’s important to have yearly urine tests at your doctor’s office. A first sign of diabetic kidney disease (known as diabetic nephropathy) is an elevated amount of albumin in the urine. Albumin is a water-soluble protein that binds with other substances in the body to help them get where they need to go (think certain nutrients and medications that need to affect certain parts of the body.) Diabetic patients should get annual blood, urine and blood pressure tests to ensure early detection of any issues. In addition, maintaining or controlling your diabetes with your doctor can decrease the chance of developing severe kidney disease or kidney failure later in life.
Kidney failure may come with a change in blood work, weight gain, ankle swelling, weakness, increased fatigue, itching, leg muscle cramps, and anemia. If kidneys have indeed been damaged, doctors will perform a kidney function test to see how well your kidneys are adapting to the changes caused by diabetes. Physicians may prescribe certain medications that slow the loss of kidney function, or ask patients to follow a restricted diet. If kidney failure cannot be controlled using these steps, dialysis or kidney transplant may be recommended. A kidney transplant is ordered when kidneys reach end stage renal failure, or when your kidneys function at only 10 or 15 percent.
Kidney failure from diabetes occurs slowly, over many years. You should not wait until you see symptoms of renal failure to see a doctor about your kidney function. Begin and maintain healthy lifestyle habits to increase your chance of keeping your kidneys as healthy as possible. Stop smoking. Limit sodium in your diet, and if you need to, work with a dietitian to develop a kidney-friendly meal plan. Make sure to get regular, daily moderate exercise. Maintain a healthy weight and get enough sleep each night. Take all medicines as prescribed by your doctor.
Diabetes affects almost all parts of your body, but kidney failure is a serious concern for most diabetics. The kidneys control the health and function of your blood, which touches every part of you. With careful consideration of your symptoms and regular monitoring by your doctor, you can detect and treat the earliest signs of kidney failure and prolong the function of your kidneys for as long as possible.
Dr. Gildardo Ceballos
Internal Medicine
OakBend Medical Group
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.
Resources:
https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work
https://medlineplus.gov/diabetickidneyproblems.html
https://www.kidney.org/atoz/content/diabetes
