The immediate cause of kidney disease in diabetics is high blood sugar, which damages structures inside the kidneys and forces them to work harder. This leads to a decline in kidney function. Diabetes also tends to increase the risk of high blood pressure, and this can contribute to the development of kidney disease or can make it worse. Problems with the kidneys in diabetic patients are known as diabetic nephropathy or diabetic kidney disease (DKD).
In patients with diabetes, the ability to regulate blood sugar is impaired. Patients can maintain stable levels with the use of dietary measures, exercise, and medications. If they fail to do so, the blood sugar can spike. This puts pressure on blood vessels throughout the body, including in the kidneys, and can damage the kidneys over time. They will start to leak protein into the urine, and a snowball effect can happen, where the kidneys get worse and worse if the patient does not receive treatment.
High blood glucose tends to increase blood pressure, and this can contribute to kidney disease in diabetics. The high blood pressure makes the kidneys work even harder, and they will become less efficient over time. The patient's urine chemistry will change. In addition to having lots of sugar, the urine will also contain proteins that the body should be retaining but cannot because the kidneys aren't working right. The patient may also develop edema, or depositions of fluid in the extremities that cause them to swell.
Another issue with kidney disease in diabetics is infections. Uncontrolled diabetes tends to cause neurological problems, and patients may not always urinate in a timely fashion because they don't get the signal that their bladders are full. This increases the risk of infections, as bacteria love high sugar environments. An untreated infection can travel to the kidneys and cause scarring that will limit kidney function and contribute to the increased severity of kidney disease in diabetics.
Diabetes is one of the leading causes of kidney failure around the world. Kidney disease in diabetics is preventable, if patients maintain a rigorous treatment plan and monitor their health. In the event it does start to develop, routine medical testing can catch early warning signs. The test results can be a reminder to control diabetes more effectively to prevent complications like kidney disease. Once the kidneys fail, the patient will need dialysis or a transplant to survive.
