Kidney Disease and Diabetes
By Nina Nazor
How to Protect
Why is kidney disease caused by diabetes?
High blood glucose levels are toxic. When these high levels are sustained over a long period
of time the arteries get damaged. Those arteries might be large, like the coronary arteries, or they can be as small and thin
as a hair, such as the ones in the eyes or kidneys. That is why diabetes damages the eyes, the kidneys and is a risk factor
for cardiovascular disease.
The good news is that with tight (strict) control
you can prevent or delay the development of kidney problems. So, lets see what is kidney disease and all the things you can
do to avoid it.
What is the function of the kidneys?
Our kidneys are the filters of our blood. They clean and recycle different substances and help
get rid of toxic wastes through the urine using a very delicate and intricate network of blood vessels for their interchange
of various substances.
How is kidney disease developed?
- Kidney disease in
diabetes develops over the years. The first stage happens when the kidneys increase their filtering function. This process
takes a few years to develop and is called hyperfiltration.
- Later, on the long run, the kidneys start leaking albumin (a protein
present in the blood) into the urine. This is known as microalbuminuria. That is why you should have a test to detect microalbuminuria
every year to check your kidney function.
- As kidney disease progresses the amount of albumin leaking into the urine increases. This stage
is called diabetic nephropathy or macroalbuminuria. Then, the kidney's filtering function begins to slow down, the body
starts retaining waste toxics due to the lack of filtration. Creatinine is one of those toxics, so the measurement of creatinine
in urine can reflect the reduction in kidney function. When kidneys are damaged, blood pressure usually rises.
- The final stage is
kidney failure. This often happens after having diabetes for up to 15 or 20 years. That is why strict control of blood glucose
is so important to prevent the development of kidney problems.
is the relationship between high blood pressure and kidney disease?
family history of high blood pressure and/or the presence of hypertension increase the risk to develop kidney disease and
hypertension speeds the progress of kidney disease when it already exists.
How to prevent kidney disease?
have shown to slow down the progression of kidney disease, especially angiotensin-converting enzyme (ACE) inhibitors and angiotensin
receptor blockers (ARBs). Also, in addition to an ACE inhibitor or an ARB, a diuretic is sometimes useful. Other blood pressure
drugs may also be needed, such as beta-blockers and calcium channel blockers.
If you have diabetes, following a high protein diet
can be harmful for the kidneys. Experts recommend that people with kidney disease and diabetes follow the guidelines for a
healthy diet but avoid eating a high protein diet. When there is greatly reduced kidney function, it might be necessary to
reduce the intake of protein in order to delay the onset of kidney failure.
Tight Control of Blood Glucose
Maintaining near normal
blood glucose levels has shown great promise for people with type 1 and type 2 diabetes, especially for those in early stages
Dialysis and Transplantation
People who develop kidney failure must undergo either dialysis or a kidney transplant.
Several areas of research
supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health hold
great potential. Discovery of ways to predict who will develop kidney disease may lead to greater prevention in people with
diabetes. Also, the discovery of better anti-rejection drugs will improve results of kidney transplantation and for some people
with type 1 diabetes, advances in transplantation--especially transplantation of insulin-producing cells of the pancreas--could
lead to a cure for both diabetes and the kidney developed by diabetes.
National Kidney and Urologic Diseases Information Clearinghouse