One of the more common long-term complications of diabetes is kidney damage, also known as diabetic nephropathy or diabetic kidney disease. This condition is a result of vascular abnormalities that accompany diabetes and increases mortality risk. Type 2 diabetes is also a risk factor for end-stage renal disease (ESRD), the most advanced stage of kidney disease.
Chronic kidney disease basics
Kidney disease means the kidneys can’t filter blood and make urine as they should. Chronic kidney disease occurs slowly over many years and usually can’t be reversed.
- Early kidney disease, sometimes called renal insufficiency
You may have no signs or symptoms until the disease is advanced, but the damage is still being done. Blood tests to check kidney filtration rate and urine tests to check for protein in your urine are the only ways to find out if you have kidney disease at this stage. It’s important to be tested for kidney disease if you have diabetes so it can be detected and treated early to slow progression of the damage. Keeping your blood sugar and blood pressure under control are very important to slow kidney disease. Losing weight, getting regular exercise and not smoking are great ways to help control blood sugar and blood pressure.
- Kidney failure, or end-stage renal disease
Kidney failure means damage to the kidneys has progressed to the point that they are not doing a good job of filtering wastes such as urea and creatinine from the blood so it can be excreted in the urine. The waste buildup can make you sick. You may have these symptoms: swelling of the ankles or face, vomiting, loss of appetite, fatigue, confusion and headaches. Treatments for kidney failure may include: hemodialysis, peritoneal dialysis or a kidney transplant. It’s important to work with your health care team to decide which treatment is best for you.
How does diabetes increase the risk for kidney disease?
High levels of blood sugar make the kidneys work harder to do their filtering job. Over time, this can damage your kidneys so they start to leak small amounts of protein (albumin) into the urine. The American Diabetes Association suggests that people with Type 2 diabetes have an albumin-to-creatinine ratio (ACR) test at the time of diagnosis and once a year thereafter. Detecting albumin in a urine test indicates kidney damage. But not everyone with diabetes develops kidney disease. The better you keep you diabetes and blood pressure under control, the lower your chance of getting kidney disease.
How are cardiovascular disease and chronic kidney disease related?
People with CKD have an increased risk for cardiovascular disease mostly due to problems with the blood vessels. Most patients with CKD die as a result of cardiovascular complications rather than progress to end-stage renal disease.
These risk factors often associated with kidney disease are also associated with atherosclerosis and contribute to the risk of developing CVD and stroke:
- High blood pressure
- High LDL (bad) cholesterol
- Low HDL (good) cholesterol
- Lack of physical activity
- Older age
What should I do if I have diabetes?
Many of the risk factors for kidney disease and CVD are treatable. If you have diabetes, take these steps: