Diabetes and Kidney Disease: What’s The Connection?

Diabetes patients have a lot to manage when it comes to their health. Diabetes can come with health complications, and it can sometimes lead to kidney disease. 

Unless you know how to tackle the problem, you will eventually bite off more than you can chew. 

Based on the latest CDC reports, 463 million adults are dealing with diabetes around the world. 34.2 million are in the United States, which is exactly 10.5% of the population. 

Over the years, diabetes rates have skyrocketed, leading to several new cases every year. Experts estimate that by 2030 about 54.9 million Americans will have undiagnosed and diagnosed diabetes. 

Here, we will take a closer look at the connection between diabetes and kidney disease. How to identify the problem, recognize the causes, and avoid the potential risk factors. We also list some practical tips on maintaining proper kidney health with diabetes.

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What’s The Link Between Kidney Disease and Diabetes?

The primary purpose of each kidney is to filter the waste from the blood and get the cleaned blood back into the system. When the kidney experiences kidney failure, it means that the organ can’t filter the waste. Nor can it keep adequate fluid levels and salts that the body needs.

Diabetes mellitus is one of the main reasons for kidney failure. Most people (90-95%) with diabetes have type 2 diabetes. This metabolic condition is typically recognized by the high blood sugar (blood glucose) level. 

To understand how diabetes and kidney disease are related, you need to know why diabetes is hard on the kidneys. With time, elevated blood sugar damages the countless tiny filtering units present in every kidney. This can lead to end-stage kidney disease or kidney failure. 

From 20% to 30% of diabetes patients experience diabetic nephropathy (kidney disease), even if not all cases will turn to kidney failure. A diabetic patient is vulnerable to nephropathy, regardless of whether they use insulin or not. The risk of nephropathy is connected to the amount of time that an individual has had diabetes. 

Over 35% of individuals with diabetes 20 years or older already have chronic kidney disease (CKD). Based on 2016 reports, 1 in 10 American adults had diabetes. 

How Long Does Diabetes Take To Damage Kidneys?

Type 1 diabetes and type 2 diabetes may have a somewhat different impact on the kidneys. With type 2 diabetes, fluctuating blood sugar and blood pressure can damage the kidney filters. This could trigger protein to leak into the urine. 

The onset of kidney damage could start 10 to 15 years after diabetes develops. As the kidney damage gets worse, each kidney has trouble cleansing the blood. With long-term damage, the kidney might stop working. 

With type 1 diabetes, almost all of those affected experience some functional kidney changes in 2 to 5 years after their diagnosis. Roughly 30% to 40% of cases progress to serious kidney disease. This typically happens in around 10 to 30 years. 

The course of type 2 diabetes (non-insulin-dependent disease) isn’t that defined. However, experts estimate it follows a similar course. The main difference is that it happens in older patients. 

What Is the Life Expectancy of a Diabetic With Kidney Disease?

According to a 2017 study, diabetes with early kidney involvement, like diabetic nephropathy, could reduce life expectancy by 16 years. The research focused on identifying the excess risks linked with diabetes and early diabetic kidney disease. 

Although taking the necessary actions to reduce lifestyle risks can be tricky, it can save lives. 

Can You Reverse Kidney Damage Caused by Diabetes?

Damage to the kidneys from diabetic nephropathy can’t be reversed. The problem is, people don’t usually feel diabetic nephropathy until diabetes has led to significant damage. When the organs can no longer do their job, doctors may suggest peritoneal dialysis. 

Clear Signs of Diabetic Kidney Disease

Diabetic nephropathy is a pressing ailment from type 2 diabetes and type 1 diabetes. Nephropathy slowly but surely damages the filtering system of the kidneys, causing a range of symptoms. 

When the kidney disease forms, nephropathy most likely won’t cause any symptoms. But, as it gets progressively worse, your body will start reacting to it. 

You can spot the signs of nephropathy if you pay close attention to the changes in your body. These could include:

  • Bad blood pressure control

  • A constant need to urinate 

  • A protein present in the urine (albuminuria)

  • Swelling in the hands, ankles, feet, or eyes

  • Shortness of breath

  • Appetite loss

  • Trouble staying focused

  • A decreased need for diabetes medicine or insulin

  • Vomiting accompanied by nausea

  • Constant itching

Testing for diabetic kidney disease

A glomerular filtration rate (GFR) test can check how the kidneys are doing. The glomerular filtration rate measures the filtering. 

The doctor could suggest a glomerular filtration rate test if you have signs that the kidneys aren’t working as they are supposed to. 

Glomerular hyperfiltration is a situation when the kidneys create massive amounts of pro-urine. The normal eGFR is 60 or more. 

If the eGFR is less than that for more than three months, then the kidneys aren’t working normally. So, the eGFR rate is important to assess the state of the kidneys. Elevated serum creatinine is also a sign of impaired function. 

The blood pressure also becomes difficult to control when the kidney function is thrown out of sync. With regular blood pressure fluctuations, diabetes is harder to manage. 

That’s why it’s crucial to see a doctor if you have any of these signs. That way, you can prevent further disease progression. 

Albuminuria

The most crucial and earliest sign of diabetic kidney disease is the elevated excretion of albumin in the urine. 

Albuminuria is a condition that causes excess protein in the urine, and it’s the result of a damaged kidney. Albuminuria in diabetes may be triggered by a prolonged increase in blood glucose or blood pressure. 

The symptoms of albuminuria are only easy to spot when the kidney has become highly damaged. That’s why albuminuria leads to increased protein levels. 

People provide a urine sample to detect unstable protein levels. They then compare the ratio of albumin to creatine. A normal albumin ratio is 2.5 mg/mmol or less in men. In comparison, a healthy albumin ratio is 3.5 mg/mmol or less in women. 

So, it would be in your best interest to contact a specialist the moment you spot albuminuria signs. The unstable urinary albumin and decreased renal function need treatment. 

Probable Causes

Both type 1 diabetes and type 2 diabetes can lead to nephropathy. The goal is to avoid end-stage renal disease as much as possible. 

Elevated blood glucose, commonly called blood sugar, could trigger blood vessel damage to the kidneys. The moment blood vessels begin to suffer damage, their normal functions start to decline. 

A lot of people with type 2 diabetes also experience unstable blood pressure. The blood pressure too can damage the kidneys. The blood pressure is constricting and narrowing down the blood vessels. This, in turn, affects the normal flow of blood. 

Without adequate circulation, the kidneys are unable to filter the waste and additional fluid. So, the fluid keeps piling up inside the vessels, raising the blood pressure even further. 

In the United States, almost 1 in 2 adults (108 million) experience elevated blood pressure. The skyrocketing blood pressure is the 2nd leading cause of kidney failure in the country after diabetes. 

Potential Risk Factors for Diabetic Kidney Disease

Living with diabetes mellitus (either type 1 or type 2 diabetes) can predispose a person to diabetic kidney disease. Poor kidney function or nephropathy can lead to various health problems, like diabetic retinopathy and renal outcomes. 

Keeping nephropathy in check and lessening the odds of renal disease begin with recognizing each potential risk factor. 

The risks associated with diabetic kidney disease are:

  • Unstable blood sugar level (hyperglycemia)

  • Unstable blood pressure level (hypertension)

  • Physical inactivity with a metabolic disease

  • Obesity

  • Cardiovascular disease 

  • High intake of foods packed with salt with a metabolic disease

  • Not sticking to a diabetes mellitus eating plan

  • Having a history of diabetic kidney disease (diabetic nephropathy)

Plus, many reports indicate that individuals with a metabolic ailment have a risk for acute kidney injury. The rates of this kind of kidney injury are much higher in those who recently had surgery, took specific medications, or had sepsis

How Can Diabetics Take Care of Their Kidneys?

To delay or prevent nephropathy, the key is sticking to a healthy lifestyle and managing hypertension. These tips can help:

  • Doing regular exercises reduce the onset of diabetic nephropathy. 

  • Keeping the blood glucose level stable for lesser odds of kidney disease or nephropathy.

  • Getting early screenings for diabetic kidney disease.

  • Quitting smoking to decrease the chance of the disease damaging the organs or leading to diabetic nephropathy.  

Conclusion

When dealing with a metabolic disease, like type 1 or type 2 diabetes, the kidneys can get damaged and develop diabetic nephropathy. 

Diabetic nephropathy can then become a threat to controlling the metabolic disease. Regular doctor visits and healthy lifestyle choices with type 1 and type 2 diabetes can help with disease management and avoiding renal failure.

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Sources

  1. Wen CP, Chang CH, Tsai MK, Lee JH, Lu PJ, Tsai SP, Wen C, Chen CH, Kao CW, Tsao CK, Wu X. Diabetes with early kidney involvement may shorten life expectancy by 16 years. Kidney Int. 2017. https://pubmed.ncbi.nlm.nih.gov/28577854/
  2. de Zeeuw, D., Parving, H., & Henning, R. (2006). Microalbuminuria as an Early Marker for Cardiovascular Disease. Journal Of The American Society Of Nephrology, 17(8), 2100-2105. https://jasn.asnjournals.org/content/17/8/2100
  3. Yu SM, Bonventre JV. Acute Kidney Injury and Progression of Diabetic Kidney Disease. Adv Chronic Kidney Dis. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898826/

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