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Diabetes & Kidney Disease

Diabetics face a high risk of developing kidney disease, according to the National Kidney Foundation (NKF). The nonprofit organization estimates that roughly 30 percent of those diagnosed with juvenile onset (Type 1) diabetes and 10 percent to 40 percent of adult onset (Type 2) diabetics will eventually face kidney failure. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reports that diabetes accounts for almost 44 percent of all kidney failure cases.

  1. How Kidneys Work

    • The kidneys are designed to filter out waste products in the latter stages of the digestive process. According to the NKF, each kidney has roughly a million working units called nephrons, each of which contains a massive network of tiny blood vessels, called a glomerulus (known collectively as glomeruli), and a tubule. As the blood is filtered through the glomeruli, waste products are passed off through the tubules and eventually are eliminated from the body as urine.

    Kidneys Overworked

    • The high blood-sugar levels characteristic of diabetes put an extra burden on the kidneys, eventually compromising their ability to filter out waste and to ensure that proteins and other nutrients remain in the blood. The NIDDK says the first sign of weakness in the kidney filtration system is the leakage of albumin, a blood protein, into the urine. According to the American Diabetes Association (ADA), this leakage, called microalbuminuria in its early stages, can eventually progress to macroalbuminuria, during which massive amounts of albumin are leaked into the urine. Barring medical intervention, macroalbuminuria usually progresses to end-stage renal disease (ESRD), in which the kidneys shut down completely.

    Keeping Kidneys Healthy

    • As the statistics indicate, not all diabetics develop kidney disease. The ADA emphasizes that diabetics can lower their risk of kidney disease by keeping blood-glucose levels within their target range and also by maintaining healthy blood-pressure levels. The ADA claims that research has shown that tight blood-sugar control by diabetics who are already suffering from microalbuminuria can cut the risk of progression to macroalbuminuria by 50 percent.

    Slow Progression

    • The NIDDK says that diabetes-related damage to the kidneys rarely occurs during the first 10 years after diabetes is diagnosed, "and usually 15 to 25 years will pass before kidney failure occurs." For diabetics who have lived for 25 years or more with no sign of kidney failure, the institute suggests that the chances of it developing are minimal.

    Regular Testing Vital

    • Diabetics should be tested regularly for signs that kidney disease is present or may be developing. The two key indicators of kidney disease are eGFR (estimated glomerular filtration rate) and urine albumin. The eGFR is calculated by measuring how much creatinine, a waste product, is present in the blood. The NIDKK indicates that kidney disease is present if the eGFR falls below 60 milliliters a minute. Urine albumin is tested by measuring the ratio of albumin to creatinine in the urine. An albumin level higher than 30 milligrams per gram of creatinine confirms the presence of kidney disease, according to the NIDKK.

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