Diabetes & Kidney Disease

Walid Aboujaoude, MD
Hypertension and Kidney Diseases Specialist
Head of Nephrology Division at MEIH

Diabetic nephropathy is kidney disease or damage that can occur in people with diabetes.

 

Causes, Incidence, And Risk Factors

Each kidney is made of hundreds of thousands of small units called nephrons that filter your blood and help remove waste from your body.

In people with diabetes, these nephrons thicken and slowly become scarred over time even before any symptoms begin.

The exact cause is unknown. However, kidney damage is more likely if there is poor control of diabetes and high blood pressure. Family history and ethnicity may also play a role.

Not everyone with diabetes develops this kidney problem.

People with diabetes who smoke and those with Type 1 diabetes that started before age 20 have a higher risk for kidney problems.

Symptoms

Often, symptoms can occur 5-10 years after the kidney damage had started.

People who have more severe kidney disease may have symptoms such as constant fatigue, general ill feeling, headache, nausea and vomiting, poor appetite, and swelling of the legs.

Signs And Tests

Your doctor can order tests to detect signs of kidney problems in the early stages. Once a year, you should have a urine test to look for a protein called albumin leaking into the urine Too much of this protein leaking is often a sign of kidney damage.

High blood pressure often goes along with diabetic nephropathy. You may have high blood pressure that begins quickly or is hard to control. Your doctor will also check your BUN and Serum creatinine every year.

In case of doubt, a kidney biopsy confirms the diagnosis.

Treatment

In early stages, kidney damage can be slowed with treatment. Keeping your blood pressure under control (below 130/80) is one of the best ways to slow kidney damage.

Eating a low-fat diet, taking drugs to control blood cholesterol, and getting regular exercise can also help prevent or slow kidney damage.

You can also slow kidney damage by controlling your blood sugar levels, which you can do by:

  • Eating a healthy diet
  • Regularly taking insulin or other medicines your doctor prescribes.
  • Knowing the basic steps for managing your blood sugar levels at home.
  • Checking your blood sugar levels and keeping a record of them.

 

To protect your kidneys, remember the following:

  • Tell your doctor about your diabetes before having an MRI, CT scan, or other imaging test in which you receive a contrast dye. These dyes can further damage the kidneys.
  • Always talk to your health care provider before taking any drugs since some can damage the kidneys.
  • Know the signs of urinary tract infections and get treated right away.

Expectations (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.

Thus it is very important to consult your doctor about your diabetes and if there is any kidney involvement from it.

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