Caregivers Preventing Diabetic Kidney Disease

What is diabetic kidney disease?

Diabetic kidney disease is a decrease in kidney function that occurs in some people who have diabetes. It means that your kidneys are not doing their job as well as they once did to remove waste products and excess fluid from your body. These wastes can build up in your body and cause damage to other organs.

Are some people more likely to get diabetic kidney disease?

Yes. The following risk factors have been linked to increased risk of developing this disease: high blood pressure, poor glucose (sugar) control, inherited tendency and diet.

How do I know if my kidneys are affected?

In the early stages, there may not be any symptoms. As kidney function decreases further, toxic wastes build up, and patients often feel sick to their stomachs and throw up, lose their appetites, have hiccups and gain weight due to fluid retention. If left untreated, patients can develop heart failure and fluid in their lungs.

Are there tests that can be done?

Yes. The diagnosis is based on the presence of abnormal amounts of protein in the urine. A wide variety of tests can be done to tell if a person has kidney disease. The most widely used are serum creatinine and BUN (blood urea nitrogen). Other more sensitive tests are: creatinine clearance, glomerular filtration rate (GFR) and urine albumin.

How long does it take for your kidneys to become affected?

Almost all patients with Type I diabetes develop some evidence of functional change in the kidneys within two to five years of the diagnosis. About 30 to 40 percent progress to more serious kidney disease, usually within about 10 to 30 years.The course of Type II (adult-onset or non-insulin-dependent) diabetes is less well defined, but it is believed to follow a similar course, except that it occurs at an older age.

What can I do to prevent kidney disease?

There is evidence that careful control of glucose (sugar) helps to prevent kidney disease in people with diabetes. You should follow your doctor’s orders carefully regarding diet and medicines to help control your glucose levels.

If my kidneys are already affected, can I keep them from getting worse?

It may be possible to prevent or delay the progression of kidney disease. Since high blood pressure is one of the major factors that predict which diabetics will develop serious kidney disease, it is important to take your high blood pressure pills faithfully if you do have high blood pressure. Your doctor may also recommend that you follow a low-protein diet, which reduces the amount of work your kidneys have to do. You should also continue to follow your diabetic diet and to take all your prescribed medicines.How many people with diabetic kidney disease develop total kidney failure?About 30 percent of the people with Type I diabetes and about 10 to 40 percent of the people with Type II diabetes will eventually develop end-stage kidney failure, requiring treatment to maintain life. Certain population groups, such as African Americans, Hispanic Americans and Native Americans, have a higher risk of developing kidney failure from Type II diabetes than Caucasian Americans.

If my kidneys do fail, what can I do?

If your kidneys fail, you can receive dialysis treatments or you may be a candidate for a kidney transplant. Two types of dialysis are available–hemodialysis and peritoneal dialysis. Your doctor will discuss these treatment options with you. The decision about which treatment is best for you will be based on your medical condition, your lifestyle and your personal preference. (For more information about these treatments, see National Kidney Foundation brochures)