Diabetes & Kidneys
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Too much glucose (sugar) in the blood for a long time can
cause diabetes problems. This high blood glucose (also called
blood sugar) can damage many parts of the body, such as the
heart, blood vessels, eyes, and kidneys. Heart and blood
vessel disease can lead to heart attacks and strokes. You can
do a lot to prevent or slow down diabetes problems.
This booklet is about kidney problems caused by diabetes.
You will learn the things you can do each day and during each
year to stay healthy and prevent diabetes problems.
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High blood glucose can cause kidney
problems.
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| Follow the healthy eating plan that you and your doctor or dietitian
have worked out. |
| Be active a total of 30 minutes most days. Ask your doctor what activities
are best for you. |
| Take your diabetes medicines at the same times each day. |
| Check your blood glucose every day. Each time you check your blood
glucose, write the number in your record book. |
| Check your feet every day for cuts, blisters, sores, swelling, redness,
or sore toenails. |
| Brush and floss your teeth and gums every day. |
| Don't smoke. |
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The kidneys act as filters to clean the blood. They get rid of
waste and extra fluid. The tiny filters throughout the kidneys are
called glomeruli (gloh-MEHR-yoo-lie).
When kidneys are healthy, the artery (AR-ter-ee) brings blood and
waste from the bloodstream into the kidney. The glomeruli clean the
blood. Then waste and extra fluid go out into the urine through the
ureter. Clean blood goes out of the kidney and back into the
bloodstream through the vein.
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You have two kidneys. Your kidneys clean
your blood and make urine. Here is a simplified drawing of
one. |
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- Keep your blood glucose as close to normal as you can. Ask
your doctor what blood glucose numbers are healthy for
you.
- Keep your blood pressure below 130/80 to help prevent kidney
damage. Blood pressure is written with two numbers separated by a
slash. For example: 120/70.
Ask your doctor what numbers
are best for you. If you take blood pressure pills, take them as
your doctor tells you. Keeping your blood pressure under control
will also slow damage to your eyes, heart, and blood
vessels.
- If needed, take blood pressure pills that can also slow down
kidney damage. Two kinds of pills can help:
- ACE (angiotensin [an-gee-oh-TEN-sin] converting enzyme)
inhibitor (in-HIB-it-ur)
- ARB (angiotensin receptor blocker)
- Follow the healthy eating plan you work out with your doctor
or dietitian. If you already have kidney problems, your dietitian
may suggest that you cut back on protein, such as meat.
- Have your kidneys checked at least once a year by having your
urine tested for small amounts of protein.
- Have any other kidney tests that your doctor thinks you
need.
- See a doctor for bladder or kidney infections right away. You
may have an infection if you have these symptoms:
- pain or burning when you urinate
- frequent urge to go to the bathroom
- urine that looks cloudy or reddish
- fever or a shaky feeling
- pain in your back or on your side below your
ribs
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If you have kidney damage, the liquid, called a contrast agent,
used for special x-ray tests can make your kidney damage worse. Your
doctor can give you extra water before and after the x ray to
protect your kidneys. Or your doctor may decide to order a test that
does not use a contrast agent.
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When kidneys are working well, the tiny filters in your kidneys,
the glomeruli, keep protein inside your body. You need the protein
to stay healthy.
High blood glucose and high blood pressure damage the kidneys'
filters. When the kidneys are damaged, the protein leaks out of the
kidneys into the urine. Damaged kidneys do not do a good job of
cleaning out waste and extra fluids. So not enough waste and fluids
go out of the body as urine. Instead, they build up in your
blood.
An early sign of kidney damage is when your kidneys leak small
amounts of a protein called albumin (al-BYOO-min) into the
urine.
With more damage, the kidneys leak more and more protein. This
problem is called proteinuria (PRO-tee-NOOR-ee-uh). More and more
wastes build up in the blood. This damage gets worse until the
kidneys fail.
Diabetic nephropathy (neh-FROP-uh-thee) is the medical term for
kidney problems caused by diabetes.
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No protein is leaking from the healthy
kidney. |
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Protein is leaking from the unhealthy
kidney. |
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Once you have kidney damage, you cannot undo it. But you can slow
it down or stop it from getting worse by doing the things listed in
the following sections:
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At first, you cannot tell. Kidney failure from diabetes happens
so slowly that you may not feel sick at all for many years. You will
not feel sick even when your kidneys do only half the job of normal
kidneys. You may not feel any signs of kidney failure until your
kidneys have almost stopped working. However, getting your urine and
blood checked every year can tell you if your kidneys are still
working.
Once your kidneys fail, you may feel sick to your stomach and
feel tired all the time. Your skin may turn yellow. You may feel
puffy, and your hands and feet may swell from extra fluid in your
body.
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First, you will need dialysis (dy-AL-ih-sis) treatment. Dialysis
is a treatment that does the work your kidneys used to do. There are
two types of dialysis. You and your doctor will decide what type
will work best for you.
- Hemodialysis (HE-mo-dy-AL-ih-sis). In hemodialysis,
your blood flows through a tube from your arm to a machine that
filters out the waste products and extra fluid. The clean blood
flows back to your arm.
- Peritoneal dialysis (PEH-rih-tuh-NEE-ul dy-AL-ih-sis).
In peritoneal dialysis, your belly is filled with a special fluid.
The fluid collects waste products and extra water from your blood.
Then the fluid is drained from your belly and thrown away.
Second, you may be able to have a kidney transplant. This
operation gives you a new kidney. The kidney can be from a close
family member, friend, or someone you do not know. You may be on
dialysis for a long time. Many people are waiting for new kidneys. A
new kidney must be a good match for your body.
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No. You will know you have kidney problems only if your doctor
checks your urine for protein. Do not wait for signs of kidney
damage to have your urine checked.
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Each year make sure your doctor checks a sample of your urine to
see if your kidneys are leaking small amounts of protein called
microalbumin (MY-kro-al-BYOO-min).
The test results will tell you how well your kidneys are
working.
Other tests can be done to check your kidneys. Your doctor might
check your blood to measure the amounts of creatinine
(kree-AT-ih-nin) and urea (yoo-REE-uh). These are waste products
your body makes. If your kidneys are not cleaning them out of your
blood, they can build up and make you sick.
Your doctor might also ask you to collect your urine in a large
container for a whole day or just overnight. Then the urine will be
checked for protein.
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National Diabetes
Information Clearinghouse
National Diabetes Education
Program
American Diabetes Association
Juvenile Diabetes Research
Foundation International
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Coma
