Each kidney is made of hundreds of thousands of small units called nephrons. These structures filter your blood, help remove waste from the body, and control fluid balance.
In people with diabetes, the nephrons slowly thicken and become scarred over time. The kidneys begin to leak and protein (albumin) passes into the urine. This damage can happen years before any symptoms begin.
Kidney damage is more likely if you:
Have uncontrolled blood sugar
Have high blood pressure
Have type 1 diabetes that began before you were 20 years old
Have family members who also have diabetes and kidney problems
Are African American, Mexican American, or Native American
Often, there are no symptoms as the kidney damage starts and slowly gets worse. Kidney damage can begin 5 to 10 years before symptoms start.
People who have more severe and long-term (chronic) kidney disease may have symptoms such as:
Taking medicine or insulin as instructed by your health care provider
Checking your blood sugar level as often as instructed and keeping a record of your blood sugar numbers so that you know how meals and activities affect your level
OTHER WAYS TO PROTECT YOUR KIDNEYS
Before having an MRI, CT scan, or other imaging test in which you receive a contrast dye, tell the health care provider who is ordering the test that you have diabetes. Contrast dye can cause more damage to your kidneys.
Before taking an NSAID pain medicine, such as ibuprofen or naproxen, ask your health care provider if there is another kind of medicine that you can take instead. NSAIDs can damage the kidneys, especially when you use them often.
Know the signs of urinary tract infections and get them treated right away.
Many resources can help you understand more about diabetes. You can also learn ways to manage your kidney disease.
The health care provider may need to stop some of your medicines because they can harm your kidneys if diabetic nephropathy is getting worse.
Diabetic kidney disease is a major cause of sickness and death in people with diabetes. It can lead to the need for dialysis or a kidney transplant.
When to Contact a Medical Professional
Call your health care provider if you have diabetes and you have not had a urine test to check for protein.
American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.
National Kidney Foundation. KDOQI Clinical practice guideline for diabetes and CKD: 2012 update. Am J Kidney Dis. 2012;60:850-886.
Parving H, Mauer M, Fioretto P, et al. Diabetic nephropathy. In: Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 38.
Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.