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Kos Diabetes Group: Diabetes and Kidney Disease [1]
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Date: 2023-01-06
Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease. Diabetic kidney disease (DKD)is also called chronic kidney disease (CKD) or diabetic nephropathy.
The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.
Each kidney is made of hundreds of thousands of small units called nephrons. In people with poorly controlled diabetes, the nephrons can slowly thicken and become scarred over time. The nephrons begin to leak, and protein (albumin) passes into the urine. This damage can happen years before any other symptoms of kidney disease begin.
Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Blood and urine tests are used to check for diabetic kidney disease. Your health care professional will check your urine for albumin and will also do a blood test to see how well your kidneys are filtering your blood.
Routine bloodwork can help catch kidney disease early
People with Type 1 diabetes should have their urine tested for albumin five years after being diagnosed. Then they should be tested each year after that. People with Type 2 diabetes should be tested at the time of diagnosis and then tested each year after that.
Many people with diabetes develop high blood pressure, which can cause further kidney damage by increasing the pressure in the delicate filtering system of the kidneys.
Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your
blood glucose is too high
blood pressure is too high
You are also more likely to develop kidney disease if you have diabetes and
smoke
don’t follow your diabetes eating plan
eat foods high in salt
are not active
are overweight
have heart disease
have a family history of kidney failure
Some ethnic groups are at greater risk for kidney damage from diabetes. These include:
Native Americans Hispanic people African-Americans
People in these groups should take extra care to protect their kidneys.
The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. The blood pressure goal for most people with diabetes is below 140/90 mm Hg.
Common medicines that lower blood pressure can also help slow kidney damage. Two types of blood pressure medicines, ACE inhibitors and ARBs, play a special role in protecting your kidneys. Each has been found to slow kidney damage in people with diabetes who have high blood pressure and diabetic kidney disease.
Kidney damage from diabetes can get worse over time. However, you can take steps to keep your kidneys healthy and help slow kidney damage to prevent or delay kidney failure. Kidney failure means that your kidneys have lost most of their ability to function— with less than 15 percent of normal kidney function remaining. However, most people with diabetes and kidney disease don’t end up with kidney failure.
patient having dialysis
When kidney damage is caught in its early stages, it can be slowed with treatment. Once larger amounts of protein appear in the urine, kidney damage will slowly get worse.
As damage gets worse, the kidneys become worse at cleansing the blood. If the damage gets bad enough, the kidneys can stop working. Kidney damage can't be reversed.
As your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience
Nausea, vomiting, and/ or a loss of appetite
Weakness and increasing fatigue
Itching
Muscle cramps (especially in your legs)
Anemia (a low blood count)
You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.
Other signs of kidney disease in people with diabetes include:
Albumin/protein in the urine
High blood pressure
Ankle and leg swelling, leg cramps
Going to the bathroom more often at night
High levels of BUN and creatinine in the blood
Less need for insulin or antidiabetic medications
Morning sickness, nausea, and vomiting
Weakness, paleness, and anemia
Itching
End-stage renal failure, or kidney failure, occurs when your kidneys are no longer able to support you in a reasonably healthy state. This happens when your kidneys function at only 10 to 15 percent of normal. When your kidneys reach this point, you must have a kidney transplant or be on dialysis to stay alive.
kidney transplant surgery
Because diabetes also may cause damage to nerves, it can lead to difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in the urine that has a high sugar level.
Be sure to treat any bladder or kidney infections right away. Signs include:
A burning feeling when you urinate A frequent urge to urinate Reddish or cloudy urine Fever Pain in your back or on your side below the ribs
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https://www.dailykos.com/stories/2023/1/6/2145441/-Kos-Diabetes-Group-Diabetes-and-Kidney-Disease
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