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 7 Day 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

Well-controlled diabetes may depend on medication, but nutrition is perhaps the most important factor. There are many foods that can be added to...

Detoxification, or detox, diets are typically short-term diets that promise to rid the body of environmental toxins. Most detox plans begin with a...

Caring for children comes with its challenges, especially for babysitters. Things can get even more complicated when those children have diabetes...

The goal of the consistent carbohydrate diet (CCD) is to eat the same amount of carbohydrates at the same times each day. Although this diet...

Evidence is mounting that consuming black cumin helps to manage type 2 diabetes. The spice lowered blood glucose levels and blocked AGE glycation...

More Articles

Diabetes has no known cure, but there are many ways to control the disease and prevent the symptoms from interfering with daily life. One major...

Steve Gilbert, the writer of the blog Without Envy, has a young daughter named Lia who has diabetes. This...

Caring for children comes with its challenges, especially for babysitters. Things can get even more complicated when those children have diabetes...

Everyone from grandmothers to physicians tout oatmeal's wholesome goodness and health benefits. But, is oatmeal good for diabetics? Limited...

Detoxification, or detox, diets are typically short-term diets that promise to rid the body of environmental toxins. Most detox plans begin with a...

This article was written exclusively for Information About Diabetes by Julia Flaherty, a type 1 diabetic college student, editor of the Arts...

Evidence is mounting that consuming black cumin helps to manage type 2 diabetes. The spice lowered blood glucose levels and blocked AGE glycation...

Food often becomes the focal point when it comes to discussing a diabetes diet, but the beverages you drink could be affecting your weight and...

When you are struggling with an illness like lupus, arthritis or asthma, the medications you take could have secondary effects on your body. What...

A healthy diabetes plan is essential in keeping low blood sugar levels, but...

Because it is Peripheral Neuropathy Awareness Week (May 7-13), this article is about a device people with neuropathy may not be aware of—a device...

Lantus is a once a day insulin injection that is taken at the same time every day. It replaces anywhere from the average three to five insulin...

The most convenient places in a fridge to store our stock of insulin may not be the best places. We tend to think our refrigerators maintain a...

There is a connection between anxiety control, inflammation and type 2 diabetes, according to a new study conducted by Rice University researchers...

The most well-known variations of diabetes are type 1 diabetes and type 2 diabetes....