Uncontrolled diabetes can have a significant impact on the kidneys, leading to a condition known as diabetic nephropathy or diabetic kidney disease.

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Diabetes is a chronic health condition characterized by elevated levels of glucose (sugar) in the blood. This happens either because the body does not produce enough insulin (a hormone that regulates blood sugar) or because the body cells does not respond properly to the insulin that is produced.

 

There are primarily three types of diabetes:

 

• Type 1 diabetes: This type occurs when the body’s immune system attacks and destroys the insulin-producing cells in the pancreas. People with type 1 diabetes require insulin injections to survive.
• Type 2 diabetes: This is the most common type of diabetes, accounting for the majority of cases. It occurs when the body becomes resistant to insulin or does not produce enough insulin to maintain normal blood sugar levels. Type 2 diabetes is often associated with lifestyle factors such as obesity, lack of physical activity, and poor diet.
• Gestational diabetes: This type of diabetes occurs during pregnancy and usually resolves after childbirth. However, women who develop gestational diabetes have an increased risk of developing type 2 diabetes later in life.

Diabetes can lead to serious complications over time if not effectively managed, including heart disease, stroke, kidney disease, nerve damage, and vision loss. However, with proper medical care, including medication, lifestyle changes (such as diet and exercise), and regular monitoring of blood sugar levels, people with diabetes can lead healthy and fulfilling lives.

 

Impact of Diabetes on Kidney Function

 

Uncontrolled diabetes can have a significant impact on the kidneys, leading to a condition known as diabetic nephropathy or diabetic kidney disease. The kidneys play a crucial role in filtering waste products and excess fluids from the blood to produce urine. However, when diabetes is not effectively managed and blood sugar levels remain consistently high over time, it can damage the small blood vessels and filters in the kidneys. This damage can result in several complications:

 

• Albuminuria: One of the earliest signs of diabetic kidney disease is the presence of protein, specifically albumin, in the urine. Healthy kidneys should keep protein in the blood, but when the filters are damaged, they allow protein to leak into the urine. This condition is known as albuminuria.
• Reduced kidney function: As diabetic kidney disease progresses, the kidneys’ ability to filter waste and excess fluids from the blood declines. This decline in kidney function is measured by the glomerular filtration rate (GFR), which indicates how well the kidneys are working. A decreased GFR is a sign of reduced kidney function.
• High blood pressure: Diabetes can also lead to high blood pressure (hypertension), which further damages the kidneys. High blood pressure puts additional strain on the already compromised blood vessels in the kidneys, accelerating kidney damage.
• Fluid retention: Damaged kidneys may not effectively remove excess fluid from the body, leading to fluid retention and swelling, particularly in the legs, ankles, or around the eyes.
• Kidney failure: In severe cases, uncontrolled diabetes can progress to kidney failure, also known as end-stage renal disease (ESRD). At this stage, the kidneys lose their ability to function properly, and dialysis or kidney transplantation may be necessary to sustain life.

It is important for individuals with diabetes to manage their condition carefully by controlling blood sugar levels, maintaining a healthy lifestyle, including a balanced diet and regular exercise, and closely monitoring their kidney function through regular medical check-ups. Early detection and intervention can help slow the progression of diabetic kidney disease and reduce the risk of complications.

 

Symptoms of Diabetes-related kidney disease

 

In the initial stages, diabetic kidney disease (nephropathy) may not cause noticeable symptoms. However, as the condition progresses, symptoms may develop. Some of the symptoms that may indicate that diabetes has impacted the kidneys include:

 

• Swelling: Also known as edema, swelling typically occurs in the legs, ankles, feet, or around the eyes. This swelling is due to fluid retention resulting from impaired kidney function.
• Decreased urination: While diabetes itself often causes frequent urination, as kidney function declines it causes decreased urination.
• Difficulty urinating: In some cases, diabetic kidney disease can lead to difficulty or pain during urination, or changes in the urine stream.
• Foamy or frothy urine: The presence of excessive protein in the urine, a condition known as proteinuria, can cause the urine to appear foamy or frothy.
• Fatigue and weakness: Kidney disease can lead to anemia (low red blood cell count), resulting in fatigue, weakness, and pale skin.
• High blood pressure: Diabetes-related kidney damage can contribute to high blood pressure (hypertension), which may be detected through routine blood pressure measurements.
• Loss of appetite and nausea: Kidney damage can lead to a buildup of waste products in the blood, which can cause loss of appetite, nausea, and vomiting.
• Unexplained weight loss: While weight loss is often associated with poorly controlled diabetes, significant and unexplained weight loss may also be a sign of advanced kidney disease.

It is important to note that these symptoms can also be caused by other conditions, so if you are experiencing any of these symptoms, it is essential to consult a doctor for an accurate diagnosis and appropriate treatment. Regular monitoring of kidney function through blood and urine tests is crucial for individuals with diabetes to detect and manage kidney disease early.

 

Reviewed By:

DR.GOPINATH VENKATESAN

CONSULTANT – NEPHROLOGIST

MBBS., MD(GENERAL MEDICINE)., DRNB