Your kidneys play a vital role in keeping your body healthy. They help remove waste from the blood and return the cleaned blood to the body. Damaged or weak kidneys are unable to perform this crucial function, which results in the buildup of waste in your body. People with diabetes are more vulnerable to kidney failure. In fact, one out of four diabetic adults is struggling with kidney disease. This life-threatening disease takes time to develop – over a period of many years. But no matter how dangerous the condition is, it is both manageable and preventable.
Kidney failure caused by diabetes is called diabetic kidney disease and it is generally caused by high blood sugar levels. The high sugar level ends up damaging the blood vessels in your kidneys because of which the organs fail to filter waste. To protect your kidneys against such a serious condition, you must pay serious attention to your blood sugar management.
What is Kidney Disease?
As mentioned above, kidneys purify the blood and pump the cleaned blood to your body. In addition to this, the organs play an important role in keeping the body’s blood pressure under control, keeping your bones healthy, balancing the body’s fluids, and helping the body in making red blood cells. This indicates that an imbalance in the functioning of the kidneys is detrimental to your overall health. When it comes to identifying the symptoms of kidney disease, it is a bit tricky. This is because when the kidney disease is in its initial stage, the person shows no symptoms. It is only through regular blood and urine tests that your doctor will be able to identify that you have the disease. The presence of albumin – the protein in your blood – in the urine indicates that the kidneys are not functioning properly. If you have had type 1 diabetes for more than five years or have type 2 diabetes, you should get tested for kidney disease.
Since the disease doesn’t show any symptoms, here are some of the diagnostic methods that are recommended to check if you have the disease:
Blood Pressure: You need to monitor your blood pressure to determine if you have the disease or not. High blood pressure is often caused by diabetic kidney disease and can contribute to the flaring up of the disease.
Urine Tests: A urine test will help your doctor find out whether there are any proteins present. The abnormally high amount of protein in your urine is one of the signs of kidney disease caused by diabetes.
Kidney Ultrasound: Some doctors might recommend you get an ultrasound. This will help them check if there are chocked arteries in your kidneys that are hampering the smooth functioning of the organ.
Blood Tests: You may also have to undergo blood tests from time to time to see if your kidneys are functioning properly.
Biopsy: In some cases, your doctor may even ask you to get a biopsy done to better understand your condition. Under this procedure, tissues will be removed from your kidney and sent to a lab for detailed examination. The process is carried out to determine if there is any other cause behind kidney damage or whether it is pre-existing diabetes that has caused this.
How Does Diabetes Affect Your Kidneys?
Diabetes can lead to various health problems. Here is a brief look at how the condition can cause kidney disease.
Urinary Tract
Urine with high amounts of sugar is home to bacteria that can cause a urinary tract infection. Even though most of the time the infection remains limited to the urinary tract, it often spreads to the kidneys.
Nerves
Since the nerves carry messages to the brain, any damage to them will make it difficult for your brain to figure out when you have to empty your bladder. A full bladder causes pressure on the kidneys and can lead to kidney damage.
Blood Vessels inside the Kidneys
Your kidneys are made up of several blood vessels. The higher sugar levels in the blood end up clogging the vessels and making them narrow. As a result, the kidneys will not receive a sufficient supply of blood. This will not only damage the kidneys but will also cause a type of protein – albumin – end up in the urine.
Other Causes and Risk Factors of Diabetic Nephropathy
Although diabetes is one of the major causes of kidney disease, there are other risk factors that can make the condition much worse. Some of them are listed below:
Age
People who are 65-year-old or above are more vulnerable to falling prey to the disease.
Smoking
Smoking is the root cause of many life-threatening diseases. People who smoke may end up having serious health conditions, with kidney disease being one of them. If you are a smoker, you should consider quitting this harmful habit right away.
Health conditions
Other health conditions, such as insulin resistance, obesity, elevated levels of blood lipids, high blood pressure and chronic inflammation may also lead to kidney failure.
Symptoms and Stages of Kidney Diseases
If you are at the early stages of kidney disease, you will likely not show any signs or symptoms. The only time you will start showing symptoms is when the waste buildups in your blood turn excessive. On the basis of your kidney’s GFR – glomerular filtration rate – the disease can be classified into the following five stages:
Stage 1:
At this stage, your kidney functions normally even though it is going through some sort of kidney damage. Overall, the kidney function will be a GFR of 90% or even more.
Stage 2:
At this stage, even though a GFR is between 60 and 89%, the kidney starts exhibiting some loss in function.
Stage 3:
Here, the loss of function is too severe and the kidney will have a GFR of between 30 and 59%.
Stage 4:
The kidney has a GFR of somewhere between 15 and 29% and the kidney starts undergoing severe loss of function.
Stage 5:
This is the stage of kidney failure. The GFR of the kidneys at this stage is under 15%.
Now that we have broken down the disease into five stages, let’s look at the symptoms that a person with kidney disease exhibits. As mentioned above, a person in the early stages of the disease will not show any symptoms. Once the condition has worsened to an extreme level, the symptoms will be prominent. Here are some of the common symptoms that a person at the last stages of the kidney disease shows:
1. Dark Urine
People with diabetic nephropathy usually have dark urine. This is because of the presence of blood in the urine.
2. Swollen Arms and Legs
Water retention in the body because of the loss of kidney function leads to swelling in the legs and arms. Fluid retention is also responsible for causing high blood pressure and may cause pulmonary edema – a condition in which there is a presence of excess fluid in the lungs.
3. Fatigue
If you are suffering from diabetic nephropathy, you are likely to feel tired a lot of time. This is mostly because of the lack of oxygen in your blood caused by the loss of kidney function. In the same manner, another visible symptom that you are most likely to exhibit is the shortness of breath.
4. Increased Need to Urinate
If you are making quite a few trips to the washroom, there might be something wrong with your kidneys. People with kidney diseases often develop the need to urinate several times during the day.
5. Confusion
People with kidney disorders have trouble concentrating and often appear to be confused. They may also experience sleep problems and often complain of hallucinations – seeing objects or things that may not exist.
6. Nausea
Nausea and vomiting are also some of the common symptoms of kidney disease. This condition is mostly caused by the buildup of uremic toxins, gastroesophageal reflux disease, ulcers, gall bladder disease or medications.
7. Loss of appetite
People with kidney failure often suffer from a loss of appetite.
8. Persistent Itching
A loss in kidney function often leads to persistent and intolerable itching. The itching could be so severe that you would have trouble sleeping. Your physician, after evaluating your health, will prescribe some medicines or ointment to make the itching subside.
9. A Metallic Taste in Your Mouth
In the last stages of kidney disease, the patient suffering from it will experience a few changes in their body. One of them is that they will feel an unexplainable metallic taste in their mouth, which is the reason they will have an aversion to food and would stop eating.
10. Heart Disease
People with kidney disease caused by diabetes may suffer from heart diseases. In some cases, the person is also vulnerable to having a heart attack or a stroke.
Treatment Available for Kidney Disease Caused by Diabetes
Early diagnosis of the disease may help your physician draft a better treatment plan for you. The early treatment will help you tackle the condition efficiently.
Drug Treatment
Your physician will prescribe medication after thoroughly evaluating your condition. The treatment will depend on your health condition and whether you have any other pre-existing conditions, which may be affected by the medication you’re about to take. Mostly, angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors play an important role in protecting kidney function and preventing damage, as they are effective in lowering blood pressure.
Other drugs, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 (SGLT2), are also effective for treating chronic kidney disease in people with type 2 diabetes. These drugs are also effective in preventing kidney disease progression and may save the patient from other serious health conditions, such as a stroke or a heart attack. Your doctor will also give you vitamin D supplements as many people with kidney disease have a low level of vitamin D. Patients are also given statin to lower their cholesterol levels.
Dietary Changes
People with kidney disease need to bring some modifications to their diets. For that, they will have to be careful when consuming the following nutrients:
Proteins
Even though protein is an important part of your healthy diet, people with kidney diseases must avoid the excess consumption of protein. This is because protein may lead to the buildups of waste in the blood, which will be harmful to the kidneys.
Potassium
People with diabetic nephropathy have higher levels of potassium in their blood. This has a negative effect on their nerve cells. This is why it is important to be a mindful when you are consuming potassium-rich food.
Water
Water is essential for your health. But, if you have kidney disease, you might be asked to reduce your water intake. This is because water retention in your body will end up increasing your blood pressure and even swelling your arms and legs.
Sodium
Sodium is notorious for increasing the blood pressure, which puts a strain on the kidneys.
Phosphorous
The excessive intake of phosphorus is not good for your bones. Many dairy foods contain phosphorous so you have to be careful when consuming such items.
Dialysis
In case of serious kidney diseases, when your kidney’s loss of function is too severe, you would need external help to get the waste removed from the blood. Since your organs cannot do it naturally, you have to undergo a procedure called kidney dialysis. Depending on the severity of the disease, a person may have to undergo the treatment three to seven times a week. A typical dialysis session takes anywhere between 2 and 10 hours.
Kidney Transplant
In case your condition has reached the final stages, you will probably be recommended by a doctor to consider a kidney transplant. Under this procedure, you will get the kidney implant if you manage to find a suitable donor. Since a person can survive on a single kidney, many are willing to donate theirs for their loved ones. However, here, the important thing is to see whether the patient’s body is accepting the new organ. People who have had a kidney transplant are kept on medications to prevent the risk of the body rejecting the new kidney.
How Should Diabetic Patients Prevent the Risk of Developing Kidney Disease?
There is a famous saying that goes, “prevention is better than cure”. Even though modern medical science has found precise treatments for many health problems, it is always better to take precautions.
1. Control Your Blood Pressure
For people with diabetes, the blood pressure goal is below 140/90 mmHg. High blood pressure is the cause of so many complications and health problems. It also makes your heart work too hard, which, in some cases, can lead to kidney and heart diseases.
2. Maintain Healthy Lifestyle
With an active and healthy lifestyle, you can tackle many health conditions. A healthy lifestyle will also help you with blood sugar management. For that, you will have to ensure that you get a good sleep of 7 to 8 hours and that you stay at a healthy weight. You should also focus on reducing salt and sodium intake and stop smoking. Your healthy lifestyle will help you manage your pre-existing health conditions in a better manner.
3. Don’t Skip Medication
Medication is quite important in keeping your blood sugar levels and your blood pressure under control. Don’t skip the medication prescribed to you and take them consistently.
4. Maintain Blood Sugar Goals
Adequate blood sugar management is important in maintaining your health. Keeping your blood sugar under control can be achieved through a good diet and exercise. A healthcare professional will also monitor your glucose levels via A1C tests. A higher number of A1C shows that you have a higher level of glucose in your blood. For many people with diabetes, the recommended A1C goal is below 7.
People with diabetes are vulnerable to a large number of diseases. The high level of sugar in your blood can damage many vital organs of your body. This is why blood sugar management is essential to keep health problems at a minimum. To better understand what lifestyle changes you can bring to manage your diabetes, you must read our eBook Hydrate to Regulate Blood Sugar.
References:
- https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-and-kidney-failure
- https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770914/
- https://www.mayoclinic.org/diseases-conditions/diabetic-nephropathy/symptoms-causes/syc-20354556