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 nephrons 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 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
Contrast dye that sometimes used with an MRI, CT scan, or other imaging test can cause more damage to your kidneys. Tell the provider who is ordering the test that you have diabetes.
Avoid taking an NSAID pain medicine, such as ibuprofen or naproxen. Ask your provider if there is another kind of medicine that you can take instead. NSAIDs can damage the kidneys, more so when you use them everyday.
Your provider may need to stop or change other medicines that can damage your kidneys.
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.
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 provider if you have diabetes and you have not had a urine test to check for protein.
American Diabetes Association. Microvascular complications and foot care. Sec. 9. In standards of medical care in diabetes -- 2015. Diabetes Care. 2015;38:S58-S66. PMID: 25537706 www.ncbi.nlm.nih.gov/pubmed/25537706.
National Kidney Foundation. KDOQI clinical practice guideline for diabetes and CKD: 2012 update. Am J Kidney Dis. 2012;60:850-886. PMID: 23067652 www.ncbi.nlm.nih.gov/pubmed/23067652.
Tong LL, Adler S. Prevention and treatment of diabetic nephropathy. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 31.
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.