Diabetes can have serious affects on kidney fucntion. Diabetic nephropathy or Diabetic kidney disease are the two most commonly used terms to describe kidney disease that has developed in a person as a result of diabetes. It is estimated that between 20 and 35 percent of people with diabetes have developed kidney disease and out of the nearly twenty six million people in the U.S. alone, 185,000 have suffered from kidney failure as a result. Diabetes is listed as the primary cause of kidney failure in forty four percent of new cases, making diabetes the leading cause of kidney failure. Kidney disease can develop in someone with diabetes even if they have their diabetes under control, but fortunately most will not develop kidney disease severe enough to progress into kidney failure.
Type 1 diabetics are more likely to develop kidney disease than type 2 diabetics, with kidney damage appearing as early as five years of diagnosis, however it is rare for kidney failure to occur within the first ten years of diagnosis, and in most cases it can take twenty years or more before any signs of kidney failure occur. However, type 2 diabetics commonly suffer from hypertension (high blood pressure) which is considered to be a major factor in the development and progression of kidney disease and its progression into kidney failure. If someone has lived with diabetes for twenty five years or more and have had no signs of kidney failure then their chances of it ever developing are significantly decreased.
Diabetes is not the only cause of kidney disease, but when it comes to diabetes, once again the primary cause is microvascular (small blood vessel) and cellular damage as a result of long periods of excessively high levels of glucose in the bloodstream, however this as well as a combination and interaction of other factors can lead to kidney disease in diabetic patients. These can include age, whether a person has type 1 or 2 diabetes, length of time since onset of diabetes, heredity, gender (more prevalent in men), overuse of pain medications (such as acetaminophen), alcohol/illegal drug abuse, poor dietary habits, high levels of cholesterol, and the presence of other medical conditions such as high blood pressure (hypertension) and hardening of the arteries (arteriosclerosis). Ethnicity also is a contributing factor as those of African, Hispanic, Pacific Island and Native American descent appear to be at increased risk. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has deemed that excessive consumption of protein may also be harmful for people with diabetes.
Your kidneys and your liver are the body's two main means of removing waste and toxins that are created through normal metabolic functions. Your kidneys also cleanse your blood of excess fluids and minerals, as well as produce hormones necessary for the health of your blood and bones and keep certain proteins in the body that it requires to remain healthy (The presence of these proteins in the urine are a key sign of kidney disease). If your kidneys are damaged and fail to work properly levels of waste products and toxins build in the bloodstream and can potentially set off a cascade of health complications. Kidney disease is progressive and happens so slowly that most people may not notice any symptoms for many years, even if their kidneys begin to operate at only fifty percent capacity. In fact many may not notice that anything is wrong even up to the point that their kidneys have almost completely ceased to function. Kidney failure occurs when damage to the kidneys has reached a point that they can no longer filter waste and excess fluids from the bloodstream, which is also known as "end-stage renal failure".
The initial stage of kidney disease usually happens over a period of several years and is known as microalbuminuria, in which small amounts of the blood protein albumin begins to leak into and appear in the urine. During this first stage the kidneys show no abnormal signs in their filtration function, in fact in some people kidney filtration may actually be higher than normal during the first few years of developing diabetes. However as a result of fluctuating blood glucose levels, they may see a condition known as glycosuria develop once the kidneys ability to reabsorb glucose has been exceeded, this occurs when blood glucose levels have reached between 180 to 200 mg/dL (10 to 11 mmol/L).
The next stage following microalbuminuria is known as macroalbuminuria also called proteinuria, which develops as kidney disease progresses and more albumin begins to leak into the urine. As the levels of albumin increases, the kidneys ability to filter waste products from the bloodstream decreases, leading to abnormally high levels of toxins and waste products to accumulate in the body. As kidney damage progresses high blood pressure commonly develops, which can further exasperate the situation and lead to more kidney damage. Also nerve tissues are very sensitive to toxic substances and as waste and toxin levels increase in the blood, severe nerve damage (neuropathy) can develop not only in the kidneys but elsewhere in the body.
The final stage of kidney disease is when the kidneys cease to function entirely or kidney failure, which is also called end-stage renal failure. Once your kidneys have reached this point, kidney dialysis is required to remove the toxins and waste products from your blood or even a kidney transplant may become necessary. However, even with the initiation of dialysis or a kidney transplant, people with diabetes are less likely to fare as well as someone that does not. This is largely due to coexisting complications of diabetes such as nerve, eye and heart/blood vessel damage which increases morbidity and mortality rates among diabetics. Kidney failure is life-threatening even without diabetes and if not treated immediately it can be fatal, so it is important to recognize the warning signs and symptoms.