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What the Kidneys Do
From 1998 to 2008, the number of people with diabetes who develop kidney disease has doubled. According to the National Kidney Foundation, “approximately 30% of people with long-term type 1 diabetes (about one in three) will develop kidney disease” (1999), and untreated, this can lead to renal failure. If kidney failure is detected early, though, and properly treated, it can be slowed and, in some cases, even reversed.
The kidneys act as a waste filter for the body, removing toxins from the blood stream and filtering them out through the urine. The kidneys play a vital role; if they are not functioning properly and left untreated, the result is end-stage renal disease (ESRD). This is a life-threatening situation with only two options available: regular dialysis treatments or a kidney transplant.
The reason people with diabetes often develop kidney disease is because they frequently have high blood pressure. The stress of long-term hypertension causes damage to the blood vessels, and these vessels act as the filters in the kidneys. If the blood vessels become damaged, the kidneys no longer function properly, and toxins are not properly excreted. So controlling blood pressure is critical to preventing kidney disease and, ultimately, renal failure.
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Early Detection is Key
For decades, kidney disease has been considered an irreversible and progressive condition that would eventually lead to renal failure. In recent years, though, research has shown that early detection can make a difference. One of the earliest symptoms of kidney disease is microalbuminuria (small amounts of protein in the blood). A 2003 study in the New England Journal of Medicine found that kidney disease can be reversed, if treated at the first sign of this symptom. “Over half of diabetics with microalbuminuria in the study recovered their kidney function with a treatment plan designed to achieve good blood glucose control, normal blood pressure, and lower cholesterol levels (www.dlife.com 2008).
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Symptoms of Diabetic Kidney Disease
Because early detection is critical for slowing the progression of kidney disease and preventing renal failure, all those who have diabetes should be familiar with the signs and symptoms of kidney disease. Symptoms include:
- Frequent urination
- Blood and/or protein in the urine
- Burning during urination
- Puffiness and swelling (edema) in the face, hands, and feet
- High blood pressure
- Skin itching
- Nausea and vomiting
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Keeping Renal Failure at Bay
The American Diabetes Association recommends that people with Type 1 diabetes have a urine test for albumin every year starting at puberty, or even more frequently if other risk factors are involved (www.dlife.com 2008). In addition to testing for microalbumin in the urine, serum creatinine should be measured annually to determine which of the five stages of ESRD a patient has reached. Another test measuring kidney function is blood urea nitrogen (BUN). Both urea and creatinine are filtered out of the bloodstream by the kidneys, if they functioning properly; thus, if the bloodstream contains high amounts of these substances, renal failure may be indicated.
The key to maintaining diabetic control and avoiding kidney disease and renal failure is seeing your healthcare provider for regular testing and management. Your diabetic team will work with you to provide a customized treatment plan to keep you as healthy as possible.
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www.dlife.com. “Diabetes and Kidney Disease.” http://www.dlife.com/dLife/do/ShowContent/type1_information/preventing_complications/kidney.html. 2008.