The kidneys filter waste products from the blood. The filtering is done by small structures (called "glomeruli") that are similar to blood vessels. In healthy kidneys, the glomeruli filter waste products from the blood but keep protein inside the body, where it can be used to keep you healthy. Filtered blood leaves the kidney and goes back into the bloodstream.
High blood glucose and high blood pressure can damage the glomeruli. If damaged, they are not able to do their filtering job as well, so protein leaks out of the kidneys into the urine. If left untreated, large amounts of protein are lost in the urine. Eventually the kidneys are so damaged that they stop working altogether.
Kidney failure from diabetes happens so slowly that you may not feel sick for many years. About 30% of people with type 1 diabetes, and 10-40% of those with type 2 diabetes will develop this kidney disease, which is called diabetic nephropathy.
Symptoms of Kidney Disease
The earliest clinical sign of kidney disease is when the kidneys leak small amounts of a protein called albumin into the urine. Some people experience weight gain and swollen ankles, and more frequent urination at night.
As the kidney damage gets worse, more protein is leaked into the urine. This is called proteinuria. More and more wastes build up in the blood, too. The person may feel nauseous, weak and tired from anemia. They may lose their appetite or suffer leg cramps.
Prevention and Treatment
You can avoid kidney disease or slow down its progress by keeping your blood glucose at normal levels and treating high blood pressure. Your doctor may check for early signs of kidney disease with a test for excess protein in the urine, called microalbuminurea.
If you have high blood pressure, your doctor or a kidney specialist called a nephrologist may prescribe ACE inhibitors or similar medications to control your blood pressure and prevent future kidney damage. If you have a small amount of protein in the urine you may also be put on a low-protein diet.
If your kidneys fail, the nephrologist will choose from three possible treatments:
SMART TIPS FOR KIDNEY CARE