Diabetes is the number one cause of chronic kidney (or renal) failure in the U.S., and kidney disease among people with diabetes has more than doubled in the past decade. According to the National Kidney Foundation, approximately 30% of people with long-term type 1 diabetes (about one in three) will develop kidney disease. The good news is that with early detection and proper treatment, kidney disease can be slowed and, in some cases, reversed.
Why Kidneys Are Crucial
The kidneys are the waste management system of the body, removing excess fluid and toxins from the blood stream and filtering them into the urine. The role they play is vital; if kidney function is significantly reduced and a patient develops end-stage renal disease (ESRD); the situation is life-threatening and a kidney transplant or regular dialysis treatments are the only treatment options.
One of the reasons people with diabetes are at a higher risk for kidney disease (also called nephropathy) is their increased incidence of high blood pressure. The stress of long-term hypertension can cause damage to the blood vessels of the nephrons, the functional filtering units of the kidney. Up to 65% of people with diabetes have high blood pressure; controlling it is essential to preventing diabetic kidney disease.
Signs and symptoms of kidney disease include:
- Frequent urination
- Blood and/or protein in the urine
- Burning during urination
- Puffiness and swelling (edema) in the face, hands, and feet
- High blood pressure
- Skin itching
- Nausea and vomiting
- Weakness
The American Diabetes Association recommends that urine tests for albumin (a type of protein) be administered to individuals with type 2 diabetes at the time of diagnosis and annually thereafter. Other measures of kidney function include blood tests for creatinine and blood urea nitrogen (BUN). Creatinine is a metabolic byproduct of creatine, the acid that supplies energy for muscle contractions, and BUN is an end-product of protein metabolism formed in the liver. Both urea and creatinine are filtered out of the bloodstream by the kidneys; high amounts of them in the bloodstream indicates renal impairment.
You may have reduced kidney function if:
- Microalbumin levels are greater than 30 mg in a 24-hour urine test
- Blood creatinine is greater than 1.2 (women) or 1.4 (men). (Note: this is a different test and measurement than urinary creatinine).
- BUN levels are greater than 8.
Ask your healthcare provider can help you interpret the lab test results.