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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.
Diabetes
Diabetes is a chronic disease in which the body cannot regulate the amount of sugar in the blood.
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
General ill feeling
Malaise is a general feeling of discomfort, illness, or lack of well-being.
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Headache
Headache
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
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Nausea and vomiting
Nausea and vomiting
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up is forcing the contents of the stomach ...
ImageRead Article Now Book Mark Article - Poor appetite
-
Swelling of the legs
Swelling of the legs
Painless swelling of the feet and ankles is a common problem, especially among older people. Abnormal buildup of fluid in the ankles, feet, and legs ...
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- 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.
Microalbuminuria
This test looks for a protein called albumin in a urine sample. Albumin can also be measured using a blood test or another urine test called the prot...
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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.
Kidney biopsy
A kidney biopsy is the removal of a small piece of kidney tissue for examination.
If you have diabetes, your provider will also check your kidneys by using the following blood tests every year:
-
Blood urea nitrogen (
BUN
)
BUN
BUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down. A test can be done to measure the amount of urea nitrogen ...
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Serum creatinine
Serum creatinine
The creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys are working. Creatinine can ...
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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.
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
Getting regular exercise
No definition available for this article.
ImageRead Article Now Book Mark Article - 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.
Resources
The following sites provide further information on diabetes:American Diabetes Association -- www. diabetes. orgJuvenile Diabetes Research Foundation ...
- American Diabetes Association -- www.diabetes.org
- National Diabetes Information Clearinghouse -- www.diabetes.niddk.nih.gov
- National Kidney Foundation -- www.kidney.org
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 .
Dialysis
Dialysis treats end-stage kidney failure. It removes harmful substances from the blood when the kidneys cannot. This article focuses on peritoneal d...
Kidney transplant
A kidney transplant is surgery to place a healthy kidney into a person with kidney failure.
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
-
Diabetes
(Alt. Medicine)
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Diabetes - type 2
(In-Depth)
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Diabetes - type 1
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Kidney stones
(In-Depth)
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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.
