How does diabetes affect my risk for kidney disease?

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If you have diabetes, you're at risk for kidney disease, also called diabetic nephropathy. In fact, diabetes is the leading cause of kidney failure.

When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.

Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria.

In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, end-stage renal disease (ESRD), is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine (dialysis).

There are things you can do to prevent, delay or treat kidney disease, including keeping blood glucose (sugar) and blood pressure on target.

Kidney disease is one of the most serious complications of diabetes. After years of diabetes, the filtering units of the kidney—called glomeruli—get scarred and cannot filter the blood efficiently. Eventually, the kidneys may fail completely, such that a person needs hemodialysis, peritoneal dialysis or a kidney transplant to survive.

With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.

Diabetes may also cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. If urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.

About 30 percent of people with type 1 (juvenile onset) diabetes and 10 to 40 percent of those with type 2 (adult onset) diabetes will eventually suffer from kidney failure.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.