Kidney Complications

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:

  • Hemodialysis. In this process, your blood flows through a tube from your arm to a machine that filters out the waste products and extra fluid. The clean blood flows back into your arm. Hemodialysis is usually done in an outpatient center. It can sometimes be done at home.

  • Peritoneal dialysis. In this approach, your abdomen is filled with a special fluid. The fluid collects waste products and extra water from your blood. Then the fluid is drained and discarded. This type of dialysis can be done at home.

  • Kidney transplant. In this major surgery, one of your failed kidneys is replaced with a healthy kidney from a close family member, friend, or someone you do not know. The new kidney must be a good match for your body.


  • Keep your blood glucose in the target zone.

  • Keep your blood pressure under control.

  • Follow a healthy eating plan.

  • Ask your doctor to do a microalbuminurea test to check kidney function at least once a year.

  • If you have kidney damage, discuss all over-the-counter and prescription medications with your doctor before taking them. Check the labels of all medications (especially pain relievers) and ask your doctor if the label indicates that they might cause kidney damage.

  • See your doctor right away if you think you may have a bladder or kidney infection. Urinary tract infections are more common in people with diabetes. Symptoms include: 
    • Pain or burning when urinating

    • Cloudy or reddish urine 

    • A need to urinate often

    • Fever or shakiness

    • Back pain or pain on your side below your ribs


The BD Diabetes Learning Center describes the causes of diabetes, its symptoms, and diabetes complications such as retinopathy and neuropathy. This site contains detailed information about blood glucose monitoring, insulin injection and safe sharps disposal. Interactive quizzes, educational literature downloads and animated demonstrations help to teach diabetes care skills.

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