Diabetes and Nephropathy (Kidney Complications)
What kidney problems can be caused by diabetes?
Kidney disease, or nephropathy, is a frequent complication of diabetes; both type 1 and type 2, and often end in
end-stage renal disease (kidney failure).
- Ten to 21% of all people with diabetes have nephropathy.
- Diabetes is the leading cause of end-stage renal disease. Diabetic nephropathy is a progressive disease that takes
several years to develop. Many tiny blood vessels in the kidney act as filters to remove wastes, chemicals, and
excess water from the blood. In diabetic nephropathy, these blood vessels are damaged, become leaky, and protein
eventually spills into the urine (proteinuria). Eventually, the damaged filters are destroyed, putting more stress
on the remaining filters and eventually causing them to become damaged. When the entire filtration system breaks
down, the kidneys fail to function, and this is called end-stage renal disease (ESRD). ESRD is a condition where the
patient requires dialysis or a kidney transplant in order to live.
- The risk of ESRD is 12 times as high in people with type 1 diabetes as in those with type 2 diabetes.
- In patients with type 1 diabetes that develop persistent proteinuria (protein in the urine), ESRD or death
usually follows after about 5-10 years.
Can diabetes-related kidney problems be prevented?
- The key to preventing diabetes-related kidney problems begins with good control of blood glucose levels, control
of blood pressure and regular screening by a health care professional.
- Because a person with diabetes can develop nephropathy and not know it, a regular visit with a health care
professional is essential. Regular visits with a health care professional can detect proteinuria early and possibly
Research has shown the efficacy of a class of anti-hypertensive drugs, ACE-inhibitors, in reducing the progression of
diabetic kidney disease.
What is needed?
In ideal circumstances, patients with diabetes will have their disease under good control and be monitored frequently
by a health care team knowledgeable in the care of diabetes.
- Health care team education is vital. Because people with diabetes have a multi-system chronic disease they are
best monitored and managed by health care professionals trained with the latest information on diabetes to help
ensure early detection and appropriate treatment of the serious complications of the disease. A team approach to
treating and monitoring this disease serves the best interests of the patient.
It is recommended that patients who have had type 1 diabetes for more than five years have an annual test for
the presence of microalbinuria. All type 2 patients should have this test at diagnosis and yearly therafter.