How Can I Tell If I Have Diabetic Kidney Disease
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.
Health care professionals use blood and urine tests 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.
You should get tested every year for kidney disease if you
- have had type 1 diabetes for more than 5 years
What Kidney Problems Can Happen
When blood sugar is high, it can damage the blood vessels in the kidneys, leading to kidney disease. This is sometimes called diabetic nephropathy .
Kidney disease is more likely in people who haven’t controlled their blood sugar levels over a long period of time. Kidney disease can get worse if someone also has high blood pressure or uses tobacco.
If doctors find kidney disease early, the damage can sometimes be reversed with treatment.
If the kidney disease gets worse, a person may need dialysis or a kidney transplant. The good news is that these days kidney disease is less likely to end up as kidney failure because of earlier detection and better treatment than in the past.
Prediabetes And Kidney Disease
If you have prediabetes, taking action to prevent type 2 diabetes is an important step in preventing kidney disease. Studies have shown that overweight people at higher risk for type 2 diabetes can prevent or delay developing it by losing 5% to 7% of their body weight, or 10 to 14 pounds for a 200-pound person. You can do that by eating healthier and getting 150 minutes of physical activity each week. CDCs National Diabetes Prevention Program lifestyle change program can help you create the healthy lifestyle habits needed to prevent type 2 diabetes. Find a program in your community or online.
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How High Blood Pressure Can Damage Kidneys
High blood pressure the second leading cause of CKD is an increase in the force of blood as it flows through your blood vessels. Over time, that force can damage the tiny vessels in the nephrons, just as it can damage blood vessels throughout the body.
The vessels in the kidney are delicate, explains Dr. Leisman. Imagine two hoses: one is high pressure and one is low pressure. Both have water coming out, but the water coming from the high-pressure hose, over time, can lead to damage.
Leisman notes that treating high blood pressure is one of the cornerstones of preventing or slowing kidney damage. In fact, some of the most common drugs used to lower blood pressure are considered a standard treatment for CKD.
What Is The Outlook
- If you have microalbuminuria , this may clear away, especially with treatment.
- If you have proteinuria , over time the disease tends to become worse and progress to end-stage kidney failure. However, the length of time this takes can vary and it may take years. If your kidneys do begin to fail you should be referred to a kidney specialist.
- Once the kidney function goes below a certain level then you will need kidney dialysis or a kidney transplant.
- A main concern is the increased risk of developing cardiovascular diseases. Cardiovascular diseases, such as heart attack and stroke, are the main causes of death in people with diabetic kidney disease. The treatments outlined above will reduce the risk of these occurring.
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Complications Of High Blood Sugar
Diabetes is one of the main causes of high blood sugar levels, but there are other causes that can impact your blood glucose and your risk for hyperglycemia.
Hyperglycemia is the medical term for high blood sugar levels. You can have temporary spikes in blood sugar after eating a large meal or as a result of medication side effects. Chronically elevated blood sugar levels are dangerous and common in those with diabetes. Without treatment, you run the risk of a diabetic coma.
Ketoacidosis is a condition that develops when elevated blood glucose levels go untreated. Without glucose to use for fuel, your body begins to burn fat instead and produces ketones. When there are too many ketones in the blood, it will turn acidic, which can very quickly lead to ketoacidosis, a diabetic coma, and even death.
People without diabetes can develop a similar condition known as ketosis, but they can tolerate a certain level of ketones because inulin is still effectively working.
Diabetic hyperosmolar syndrome is another serious complication of high blood sugar. This is more common among individuals with type 2 diabetes and is triggered by an infection or illness.
As a result of the high blood sugar, your body tries to push out the excess glucose by passing it through your urine. Without treatment, this can result in life-threatening dehydration so prompt medical attention would be necessary.
High Blood Sugar And Chronic Kidney Disease
Provided by DaVita® Dietitians
Diabetes is the most common cause of kidney failure in the United States. This metabolic disorder changes the way the body produces or uses insulin. Insulin is a hormone that helps regulate sugar in the blood.
When blood sugar levels get too high, the condition is called hyperglycemia. Hyperglycemia is a problem for people with diabetes, and it poses a significant health risk when you have chronic kidney disease . If your diabetes is not controlled, it can lead to increased loss of kidney function, cardiovascular disease, vision loss and other complications. Thats why it is vital for people with kidney disease and diabetes to learn the symptoms of high blood sugar and develop ways to prevent it.
Symptoms of hyperglycemia
If you have diabetes you are likely to have had experience with hyperglycemia. Being aware of any indicators that your blood sugar levels may be too high is an important step in controlling your blood sugar. Symptoms of hyperglycemia include the following:
- Dry skin
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What Increases My Chances Of Developing Diabetic Kidney Disease
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
African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians.
You are also more likely to develop kidney disease if you have diabetes and
- smoke
- have heart disease
- have a family history of kidney failure
Slightly Elevated Blood Sugar Linked To Kidney Damage Risk
By Lisa Rapaport, Reuters Health
5 Min Read
– People whose blood sugar levels are in the borderline range higher than normal, but not yet diabetic – might still have an increased risk of kidney problems, a Norwegian study suggests.
Compared to individuals with normal blood sugar, people with slightly abnormal glucose levels are more likely to have two problems associated with kidney disease abnormal blood filtration and more of the protein albumin in the urine, the study found.
The questions, said Dr. Robert Cohen, an endocrinology researcher at the University of Cincinnati College of Medicine who wasnt involved in the study, are, What represents abnormal `enough blood sugar to start causing problems in the kidneys that we see with full blown diabetes, and what criteria should we be using if we want to get a head start on preventing the complications of diabetes?
Globally, about one in nine adults have diabetes, which is often linked to obesity and aging and develops when the body cant properly use or make enough of the hormone insulin to convert sugar into energy.
While the link between full-blown diabetes and chronic kidney disease is well known, doctors disagree about how much sugar in the blood might pose a risk to people without the disease. They also disagree on how to diagnose and treat patients with only mildly abnormal blood glucose levels and whether its reasonable to call this condition prediabetes.
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How Does Sugar Affect The Kidneys
Sugar is not a problem for the kidneys unless the blood sugar level gets too high. This commonly occurs in both Type 1 and Type 2 diabetes. Once the blood sugar level gets higher than 180 mg/dl, the kidneys start to spill sugar into the urine. The higher the blood sugar, the more sugar comes out in the urine. If your kidneys are normal, this usually isnt a problem, but if you have diabetes, too much sugar can cause kidney damage.
A common blood test used to detect diabetes and monitor blood sugar levels over time involves the Hemoglobin A1C protein. The higher the blood sugar gets, the more sugar gets attached to this protein. Determining the levels of hemoglobin A1C helps to give an estimate of the average sugar level in the blood for the past 3 months and provides an indication of how much damage the sugar may be causing in the body, including to the kidneys. A normal HgbA1C is less than 6% for someone who doesnt have diabetes. As the HgbA1C gets higher, more damage is done.
Uncontrolled diabetes can damage the blood vessels of the kidney and destroy the kidneys filters. At this point the kidneys can no longer do their job effectively. When the blood vessels in the kidneys are injured, the kidneys cant clean the blood properly, resulting in more water and salt being retained and waste materials building up in the blood.
More Information And Support About Kidney Disease
Talk with your diabetes team. They should be able to answer most of your questions. And were here to provide support and information when you need it too.
If you have more questions, or just want someone to listen, give our helpline a call. Youll be able to talk things through with highly trained advisors who have counselling skills and an extensive knowledge of diabetes.
The National Kidney Federation have kidney disease leaflets and can put you in touch with a local group. Kidney Care UK also offers resources and support including a telephone counselling service that you may find useful.
Kidney Research UK are dedicated to research into kidney disease. Weve been working together to identify the most important areas of future research, so that we can ultimately stop kidney disease in people with diabetes.
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What Foot Problems Can Happen
Someone who has had diabetes for many years can develop foot problems because of poor blood flow in the feet and nerve damage.
Your doctor will check your feet for any signs of problems. Tell your doctor about any foot problems, such as ingrown toenails, calluses, and dry skin. Even if your feet just feel irritated because you’ve been wearing certain shoes or because you’ve had a minor sports injury, tell your doctor.
To prevent foot problems, wear comfortable shoes that fit well and keep your toenails trimmed to the shape of the toe. Exercise, which increases blood flow to the feet, can also help keep feet healthy.
What Is The Treatment For Diabetic Kidney Disease
Treatments that may be advised are discussed below. Treatments aim to:
- Prevent or delay the disease progressing to kidney failure. In particular, if you have early diabetic kidney disease it does not always progress to the proteinuria phase of the disease.
- Reduce the risk of developing cardiovascular diseases such as heart disease and stroke.
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How Can I Prevent It
Diabetic kidney disease can be prevented by keeping blood glucose in your target range. Research has shown that tight blood glucose control reduces the risk of microalbuminuria by one third. In people who already had microalbuminuria, the risk of progressing to macroalbuminuria was cut in half. Other studies have suggested that tight control can reverse microalbuminuria.
Reach Your Blood Glucose Goals
Your health care professional will test your A1C. The A1C is a blood test that shows your average blood glucose level over the past 3 months. This is different from the blood glucose checks that you may do yourself. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months.
The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. Reaching your goal numbers will help you protect your kidneys.
To reach your A1C goal, your health care professional may ask you to check your blood glucose levels. Work with your health care team to use the results to guide decisions about food, physical activity, and medicines. Ask your health care team how often you should check your blood glucose level.
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Who Is At Risk For Diabetes
“When it comes to Type 2 diabetes the risk factors can be divided into two different categories genetic or factors that are out of an individual’s control, and environmental,” says Dr. Bahagon. “On the one end, a family history of diabetes , certain races or ethnic backgrounds such as Hispanic, Asian American, American Indian and African American, a history of polycystic ovarian syndrome or gestational diabetes, in addition to age are all factors that we can’t change but increase the risk of diabetes. On the other end, areas that individuals can have an impact on include weight, physical inactivity, high blood pressure and abnormal cholesterol or triglyceride levels. This is where the importance of educating people about the risks that they have control of is extremely important.”
High Blood Sugar From Diabetes Can Damage Kidneys
Dear Pam,
My mothers blood sugar has been running over 200. Now shes been told she has kidney disease and may need dialysis. How does high blood sugar damage kidneys?
Diabetes is the most common cause of kidney problems in the United States. High blood sugar levels from poorly controlled diabetes damage the blood vessels and nephrons of the kidneys.
When your kidneys are functioning properly, the glomeruli keep protein inside the body. Your body needs this protein to stay healthy.
High blood sugar can damage the kidneys glomeruli. When the kidneys are damaged, important proteins in the blood are lost in the urine. Damaged kidneys dont do a good job of cleaning out waste and extra fluids so not enough waste and fluids go out of the body as urine.
Instead, they build up in your blood which can cause even further damage to your kidneys.
In addition to filtering the waste in your body, the kidneys also play a role in:
- Releasing the enzyme renin which controls blood pressure.
- Changing vitamin D into its active form, .
- Producing the protein erythropoietin which stimulates the production of red blood cells.
Lack of red blood cells can mean you are anemic, and can cause anemia-related fatigue.
If you have developed kidney problems as a result of diabetes, you may be feeling fatigued or really tired. You may find it hard to do some of your normal daily tasks or activities.
If this is the case, its time to talk to your healthcare provider.
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Treating High Blood Pressure When You Have Kidney Disease
High blood pressure, or hypertension, is one of the leading causes of kidney disease. Many people with high blood pressure need medicine to help lower blood pressure, which also helps to slow the progression of kidney disease. Two groups of medicines that lower blood pressure are:
- Angiotensin-converting enzyme inhibitorsAngiotensin II is a chemical in the body that narrows blood vessels by making the muscles around the blood vessels contract. It creates a chemical called angiotensin I. ACE inhibitors prevent angiotensin I from creating angiotensin II. This helps the muscles around the blood vessels relax and enlarges the blood vessels, which reduces blood pressure.
- Angiotensin receptor blockers ARBs block angiotensin II from causing the muscles around the blood vessels to contract and make the blood vessels smaller. ARBs protect the blood vessels from the effects of angiotensin II so that blood pressure stays in a safe range.
ACE inhibitors and ARBs lower blood pressure, which also helps to slow kidney damage. Some people may need to take a combination of two or more blood pressure medicines to stay below 130/80.
What medicines treat high blood pressure?
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For People With Type 2 Diabetes
At the time the diabetes is first diagnosed, about 1 in 8 people have microalbuminuria and 1 in 50 have proteinuria. This is not because diabetic kidney disease happens straightaway in some cases but because many people with type 2 diabetes do not have their diabetes diagnosed for quite some time after the disease had begun.
Of those people who do not have any kidney problem when their diabetes is diagnosed, microalbuminuria develops in about 1 in 7 people and proteinuria in 1 in 20 people, within five years.
Diabetic kidney disease is much more common in Asian and black people with diabetes than in white people.
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How Common Is Diabetic Kidney Disease
Although diabetic kidney disease is more common in people with type 1 diabetes, there are more people with type 2 diabetes and diabetic kidney disease. This is because type 2 diabetes is much more common than type 1 diabetes.
Diabetic kidney disease is actually the most common cause of kidney failure. Around one in five people needing dialysis have diabetic kidney disease.
Note: most people with diabetes do not need dialysis.