Complications of Diabetes
Heart Disease and Stroke |
Diabetic Kidney Disease |
Hypertension and Diabetic Kidney Disease |
Diabetic Eye Disease |
Diabetic Neuropathy |
Diabetic Kidney Disease
Diabetes is the most
common cause of kidney failure. However, it's also true that most people
with diabetes don't go on to have end-stage kidney disease (ESRD). There are
many things you can do to control your diabetes and minimize your risk of
kidney failure including stopping smoking and keeping blood pressure under
control. A federal study called the Diabetes Control and Complications Trial
proved in 1993 that intensive management of diabetes can reduce the risk of
kidney disease by 50 percent.
Intensive management (called
tight control) means frequent testing of blood sugar, calculating insulin
intake on the basis of diet and exercise, following a diet and exercise plan,
and talking often with a health care team whose members are skilled at treating
Early in diabetes, the
blood-filtering units of the kidneys are damaged. This means important proteins are
lost in the urine. A urine test that measures protein can show beginning diseases.
Later in the disease, the kidneys can't remove waste products from the blood.
What are the stages?
About 40 percent of people with Type
1 diabetes develop severe kidney disease and end-stage kidney failure by the age
of 50. Type 2 causes 80 percent of the end-stage kidney failure in African
Americans and Native Americans. The key to preventing kidney disease in people
with both types of diabetes is not smoking, getting regular blood pressure and urine
protein tests, and preventing high blood sugar.
Often there are no symptoms of the
disease until it progresses to the late stages. When symptoms do appear they
There are five stages of diabetic
kidney disease with the last stage being kidney failure. On average it takes a
person with diabetes over 20 years to progress to the end stage. Both types of
diabetes, Type 1 and Type 2, can lead to kidney disease. Type 1 is more likely
to lead to end-stage kidney failure.
Stage I - The flow of blood
through the kidneys increases and the kidneys get bigger. People can stay in
this stage indefinitely or advance to Stage II after many years.
Stage II - Small amounts of
blood protein known as albumin leak into the urine. This is called
Stage III - The loss of
albumin and other proteins speeds up. Some patients develop high blood pressure.
The kidneys continue to lose the ability to filter waste. Many people are first
diagnosed with kidney disease at this stage.
Stage IV - In this stage
large amounts of urine are passed through the kidneys and high blood pressure
almost always occurs.
Stage V - The ability of the
kidneys to filter waste almost stops. Kidney dialysis or transplants are
Ways to prevent diabetes kidney problems
You can prevent diabetes kidney problems through the following means:
- Keep your blood glucose levels under control. Talk to your doctor about your HbA1c test and what your goal should be.
- Keep your blood pressure under control (130/85 mmHg or lower).
- Have your kidneys checked at least once a year by having your urine tested for small amounts of protein.
- Talk to your doctor about being placed on an ACE inhibitor to protect your kidneys.
- Have any other kidney tests that your doctor recommends.
- See your doctor right away if you think you have a bladder or kidney infection.