Diabetic Kidney Disease Symptoms

Diabetes is the leading cause of kidney failure in the United States. In fact, according to the American Diabetes Association, about 43 percent of new patients needing dialysis for kidney failure are diabetics. Diabetic kidney disease, which is called diabetic nephropathy, refers to chronic kidney disease that slowly progresses over many years, causing damage and eventually resulting in permanent failure of the kidneys.

Definition

• To filter wastes from the blood and remove excess fluids, the kidneys rely on structures called nephrons. Each kidney has about a million nephrons and each nephron relies on a system of tiny blood vessels. Over time, high blood sugar damages the vessels and other parts of the nephron. As nephrons are destroyed, more wastes and fluids are retained in the blood while proteins, which should be kept in the blood, end up being excreted in the urine.

Early Signs

• Kidney disease from diabetes progresses slowly, so even though damage is being done many years can pass before symptoms begin. The earliest sign is a small amount of a protein called albumin in the urine. Unfortunately, the only way to know of its existence is through a urine test. Over time, as more of the kidneys are damaged resulting in more wastes and fluids staying in the body, other symptoms begin to appear.

Symptoms

• The first physical symptoms include high blood pressure, leg cramps, swelling of the ankles and legs, and having to go to the bathroom more frequently at night. As the disease progresses, other symptoms join in, including nausea and vomiting, sickness in the morning, weakness, anemia, and itching. Urine tests will begin to show high levels of albumin and blood tests will indicate kidney failure through high levels of two substances; blood urea nitrogen and serum creatinine. Another symptom that may arise is a reduced need for antidiabetic medications or insulin.

Stages

• Information provided by the board-certified physicians at NephrologyChannel.com states that diabetic nephropathy progresses through five distinct stages. In stage 1, which may occur before diabetes is diagnosed, high blood sugar begins to cause the kidneys to work harder. During stage 2 the diabetes is still developing, yet damage has already occurred and albumin is being secreted in the urine. Stage 3 marks damage to the nephrons that has progressed to the point where, if tested, the urine will contain more than 300 mg of albumin. This is up from 30 mg of albumin in stage 2. If it doesn't already exist, high blood pressure develops. During stage 4 the ability of the kidneys to filter the blood steadily declines, damage continues, and there is increasing albumin in the urine. At stage 5 the kidneys have reached a state of permanent failure.

Slowing the Disease

• There are two very important ways to slow the progression of diabetic nephropathy: Strict control over blood sugar and maintenance of a normal blood pressure. Restricting protein intake may not help, but a diet that is high in protein can promote further damage to the kidneys.