Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia


 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Diabetes and kidney disease

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.

Causes

 

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 begin.

Kidney damage is more likely if you:

  • Have uncontrolled blood sugar
  • Have high blood pressure
  • Have type 1 diabetes that began before you were 20 years old
  • Have family members who also have diabetes and kidney problems
  • Smoke
  • Are African American, Mexican American, or Native American

 

Symptoms

 

Often, 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:

  • Fatigue most of the time
  • General ill feeling
  • Headache
  • Nausea and vomiting
  • Poor appetite
  • Swelling of the legs
  • Itchy skin
  • Easily develop infections

 

Exams and Tests

 

Your 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.

  • Too much albumin in the urine is often a sign of kidney damage.
  • This test is also called a microalbuminuria test because it measures small amounts of albumin.

Your provider will also check your blood pressure. High blood pressure damages your kidneys and 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:

  • Blood urea nitrogen ( BUN )
  • Serum creatinine

 

Treatment

 

When 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.

  • Your provider may prescribe medicines to lower your blood pressure and protect your kidneys from more damage.
  • Taking these medicines, even when your blood pressure is in a healthy range, helps slow kidney damage.

CONTROL YOUR BLOOD SUGAR LEVEL

You can also slow kidney damage by controlling your blood sugar level through:

  • Eating healthy foods
  • Getting regular exercise
  • Taking medicine or insulin as instructed by your provider
  • Checking your blood sugar level as often as instructed and keeping a record of your blood sugar numbers so that you know how meals and activities affect your level

OTHER WAYS TO PROTECT YOUR KIDNEYS

  • Contrast dye that sometimes used with an MRI, CT scan, or other imaging test can cause more damage to your kidneys. Tell the provider who is ordering the test that you have diabetes.
  • Avoid taking an NSAID pain medicine, such as ibuprofen or naproxen. Ask your provider if there is another kind of medicine that you can take instead. NSAIDs can damage the kidneys, more so when you use them every day.
  • Your provider may need to stop or change other medicines that can damage your kidneys.
  • Know the signs of urinary tract infections and get them treated right away.

 

Support Groups

 

Many 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 Professional

 

Call your provider if you have diabetes and you have not had a urine test to check for protein.

 

 

References

Brownlee M, Aiello LP, Cooper ME, Vinik AI, Plutzky J, Boulton AJM. Complications of diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 33.

Standards of medical care in diabetes-2016: summary of revisions. Diabetes Care . 2016:39 Suppl 1:S4-S5. PMID: 26696680 www.ncbi.nlm.nih.gov/pubmed/26696680 .

Tong LL, Adler S. Prevention and treatment of diabetic nephropathy. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology . 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 31.

Vijan S. In the clinic. Type 2 diabetes. Ann Intern Med . 2015;162(5):ITC1- ITC16. PMID: 25732301 www.ncbi.nlm.nih.gov/pubmed/25732301 .

 
  • Male urinary system - illustration

    The urinary system is made up of the kidneys, ureters, urethra and bladder.

    Male urinary system

    illustration

  • Pancreas and kidneys - illustration

    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.

    Pancreas and kidneys

    illustration

  • Diabetic nephropathy - illustration

    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 kidney's ability to function starts to decline, which may eventually lead to chronic kidney failure.

    Diabetic nephropathy

    illustration

    • Male urinary system - illustration

      The urinary system is made up of the kidneys, ureters, urethra and bladder.

      Male urinary system

      illustration

    • Pancreas and kidneys - illustration

      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.

      Pancreas and kidneys

      illustration

    • Diabetic nephropathy - illustration

      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 kidney's ability to function starts to decline, which may eventually lead to chronic kidney failure.

      Diabetic nephropathy

      illustration

    A Closer Look

     

    Talking to your MD

     

    Self Care

     

    Tests for Diabetes and kidney disease

     

     

    Review Date: 7/24/2015

    Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

     
     
     

     

     

    A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



    Content is best viewed in IE9 or above, Firefox and Google Chrome browser.