Our kidneys have three main functions: (1) remove excess water from the body or to retain water when the body needs more; (2) remove wastes from the blood and return the cleaned blood back to the body; (3) produce hormones responsible for managing blood pressure, making red blood cells, and for regulating the uptake of calcium from the intestine.
Why diabetes can cause kidney disease
High blood sugar levels cause the kidneys to have to work harder by filtering more blood. All this extra work is hard on the filters. The stress causes the filters to start leaking protein into the urine and waste products then start to build up in the blood.
Early kidney failure is diagnosed when small amounts of protein in the urine are found. This is called microalbuminuria. As the kidney disease gets worse, larger amounts of protein are found in the urine (macroalbuminuria). When the kidneys fail completely, the only available treatment would be to have a kidney transplant or to start dialysis.
Prevention and/or management of kidney disease
Managing blood pressure and keeping blood sugars well controlled are extremely important for the prevention and management of kidney disease. Aim for a blood pressure of less than 130/80 mm Hg and keep blood sugars between 4 – 7 mmol/L or 90 – 130 mg/dL (before meals) and 5 – 10 mmol/L or 90 – 180 mg/dL (after meals).
Who gets kidney disease?
Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood sugar control, and blood pressure.
Screening and monitoring
It is important to have regular screening for diabetic nephropathy. Adults with type 1 who have had diabetes for more than 5 years should be screened annually. Individuals with type 2 diabetes should be screened at diagnosis of diabetes and yearly thereafter. Individuals with diabetes with albuminuria need to be monitored at least every 6 months.