How Does Diabetes Cause Kidney Failure?

Of the 100,000 people diagnosed with kidney disease each year in the U.S., 43.8 percent of them will have developed it because of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a part of the National Institutes of Health (NIH). But why does diabetes damage the kidneys? Not all diabetics develop chronic kidney disease (CKD) or renal failure, so why do some end up on dialysis or needing a kidney transplant? Why is kidney failure one of the possible symptoms of diabetes?

Kidneys are remarkable organs that filter the blood and separate waste products from circulation. The short story with diabetes, both in type 1 diabetes and type 2 diabetes, is that the disease taxes the filtration system. But the mechanism by which this happens is a little bit more complicated.

How Diabetes Can Cause Kidney Failure

Each kidney contains a million or so filtering units called nephrons. These nephrons are made up of tiny blood vessels called capillaries as well as tubules. Normally, waste can pass through the small holes in the capillaries and make their way into urine, while larger molecules remain in the bloodstream. Over time, high blood sugar levels signal a variety of metabolic and structural changes in the nephrons to scar them, thicken them, and make the capillaries more leaky.

When the nephrons are damaged, kidney disease has begun and larger molecules that used to remain in the blood pass through into the urine. The early stage of kidney damage is called microalbuminuria. Later, when larger amounts of protein pass into the urine, macroalbuminuria results. When macroalbuminuria is present, the kidneys are very damaged and end-stage renal disease (ESRD), a form of kidney failure, is likely to follow. In ESRD, dialysis (using a machine to filter the blood) or kidney transplant is necessary.

Factors that can influence the risk of a person developing renal failure include genetics, ethnicity, blood pressure, and blood sugar management. People who are African American, American Indian, Hispanic or Latino have an increased risk of developing CKD or ESRD as compared to Caucasians. In addition, tight blood glucose control decreases risk as well as controlling blood pressure.

Symptoms and Treatment of Kidney Failure

Unfortunately, there are surprisingly few symptoms of CKD or renal failure. This is because as some nephrons are damaged, others work doubly hard to make up for the difference. Waste products don't generally build up in the blood and cause symptoms until late in disease progression. By the time nausea, insomnia, edema, poor appetite, upset stomach, weakness, and difficulty concentrating occur, the kidneys are very damaged and almost all filtering capacity is gone. For this reason, if a person has diabetes, it is especially important that his or her doctor monitor kidney function at least on a yearly basis.

If CKD is detected early in the microalbuminuria stage, treatments are available that can slow the progression of kidney damage. Tight blood pressure control, lowering cholesterol levels, maintaining tight blood glucose control, and eating a low-protein diet are all possible treatments that can decrease the burden on the kidneys and delay disease progression. In addition, certain medications called angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been shown to decrease kidney damage.

Kidney failure creates a $32-billion-dollar burden on the U.S. healthcare system each year, according to NIDDK. But diabetes research continues to search for factors that may increase the risk for CKD and ESRD as well as for ways to treat or reverse the disease.

Sources: National Institutes of Health; American Diabetes Association
Photo: Pixabay

Get a Free Diabetes Meal Plan

Get a free 7-Day Diabetes Meal Plan from Constance Brown-Riggs who is a Registered Dietitian-Certified Diabetes Educator and who is also a national spokesperson for the American Dietetic Association.

Just enter in your email below to download your free Diabetes Meal Plan.

By clicking Submit, you agree to send your info to InformationAboutDiabetes.com who may contact you with updates and information and we agree to use it according to our privacy policy.

More Articles

Limiting our intake of highly processed foods, and eating more whole and lightly processed fare can boost our nutrient and fiber intake, lower...

Chamomile tea has long been prized for its calming properties, but few people realize it’s also beneficial for glucose regulation. Traditionally,...

Today, the healing benefits of essential oils are more than the claims of ancient tradition and alternative medicine. They are increasingly the...

The different sugar content of fruits can be confusing when you are trying to manage your...

There is nothing close to a one-size-fits-all exercise program for those with diabetic peripheral neuropathy. The best general advice is to...

More Articles

There is nothing close to a one-size-fits-all exercise program for those with diabetic peripheral neuropathy. The best general advice is to...

”Metabolic memory” (less commonly known as ”hyperglycemic memory” or “legacy effect”) refers to the lingering effects of a long period of either...

Limiting our intake of highly processed foods, and eating more whole and lightly processed fare can boost our nutrient and fiber intake, lower...

With such a marked increase in the number of new diabetes cases, more people are wondering if type 1 diabetes...

Keeping your blood sugar levels under control can be tough. There are so many factors that can affect blood sugar, like exercise, food, illness,...

While some celebrities aren't quick to talk about living with diabetes, others are quite transparent and inspiring - acting as advocates for the...

People with diabetes are about twice as likely to experience heart disease as those without the condition, making cardiovascular health a critical...

Pilates is an exercise method proven to improve flexibility, strength, coordination, muscular stamina, balance, and posture. Many Pilates...

It can be difficult enough to get on stage and make a roomful of strangers laugh, but for comedians suffering from type 1 or type 2 diabetes,...

All diabetics know that maintaining proper blood sugar levels is the lifeline...

Most people with insulin-dependent diabetes use syringes and lancets every day. However, many of them do not know how to dispose of these...

Explaining diabetes to children can seem like a daunting task, but in reality, it is no more difficult than discussing anything else important....

Diabetes is a complex disease, affecting virtually every part of the body. The damage it does, to nerve endings, blood vessels, organs, and the...

People with type 1 and type 2 diabetes have successfully competed in the Olympic Games. Their amazing stories prove that diabetes is no match for...

If your child has diabetes, you want him or her to be safe while in school and to have the same educational opportunities as other children....