About 20 to 30 percent of the diabetic population develop kidney disease (diabetic nephropathy) or kidney cancer. An individual with diabetes is at an increased risk of developing nephropathy whether they make use of insulin or not. The diabetic population is also at an increased risk of other kidney complications such as narrowing of the arteries supplying blood to the kidneys. This is also referred to as renovascular disease or renal artery stenosis.
Table of Contents
Feel free to skip ahead if one topic catches your eye:
- Diabetes and kidney failure
- Early signs of kidney failure
- How does diabetes affect the kidney?
- Risk factors for cancer in diabetes
- Treatment Options
1. Diabetes and kidney failure
The small blood vessels in the body get injured with Diabetes mellitus, usually called diabetes, and this results in a reduction in the ability of the kidneys to clean the blood properly. This makes the body retain more salt and water which may lead to ankle swelling, weight gain, and more protein in the urine. It also puts the body at the risk of accumulating waste materials in the blood. Diabetes can also cause nerve damage in the body and difficulties in emptying the bladder. The pressure exerted from a full bladder may back up and injure the kidneys.
The most common types of diabetes are Type 1 and Type 2. Type 1 diabetes, also referred to as insulin-dependent diabetes mellitus or juvenile-onset diabetes mellitus, generally occurs in children. In this type of diabetes, the pancreas loses its ability to make sufficient insulin and patients have to take regular insulin injections for the rest of their life.
On the other hand, Type 2 diabetes (also referred to as non-insulin-dependent diabetes mellitus or adult-onset diabetes mellitus) is more common and generally happens in people above the age of 40. In this type of diabetes, the pancreas makes sufficient insulin but the body is unable to make use of it properly. The high levels of blood sugar may be controlled to some extent by taking medications, following a proper diet and taking insulin injections.
Diabetic kidney disease can be described as a reduction in kidney function that happens in some people with diabetes. This means that the kidneys are not able to perform their routine functions of removing excess fluid and waste products from the body. These wastes may build up in the body and result in damage to other organs of the body.
The risk factors that are associated with the development of diabetic kidney disease are inherited tendency, poor glucose (sugar) control, high blood pressure, and diet. The risk of diabetic nephropathy is higher if the patient has type 1 or type 2 diabetes and other factors may include uncontrolled high blood pressure (hypertension), uncontrolled high blood sugar (hyperglycemia), smoking, high blood cholesterol, or a family history of kidney disease or diabetes.
Over time, the complications of diabetic nephropathy may develop and may include a rise in the levels of potassium in the blood, anaemia, fluid retention, pulmonary edema, diabetic retinopathy, erectile dysfunction, diarrhoea, foot sores, end-stage kidney disease, pregnancy complications, cardiovascular disease, or stroke.
2. Early signs of kidney failure
The early signs and symptoms of kidney failure include:
- Increased need to urinate
- Swelling of ankles, hands, eyes, or feet
- Worsening blood pressure control
- Vomiting and nausea
- Fatigue
- Loss of appetite
- Protein in the urine
- Shortness of breath
- Difficulty in concentrating or confusion
- Reduced need for diabetes medicine or insulin
- Chest pain or pressure
- Irregular heartbeat
It is important for you to seek immediate medical intervention if you experience any of the above signs and symptoms of kidney failure.
3. How does diabetes affect the kidney?
Diabetes can pose threats to the kidneys by causing damage to:
- Nerves in the body: Diabetes can lead to nerve damage in the body. Nerves are critical components of the human body and carry messages between the brain and other body parts and organs, including the bladder. They notify the brain when the bladder is full. Damaged bladder nerves mean loss of sensation when the bladder is full and the pressure exerted by a full bladder may damage the kidneys.
- Blood vessels inside the kidney: The kidney’s filtering units comprises small blood vessels. High blood sugar levels over time may result in the narrowing or clogging of these vessels. The kidneys become damaged without sufficient blood and albumin, a form of protein, ends up finding a place in the urine.
- Urinary tract: If urine stays in the bladder for long, it may result in urinary tract infection because of bacteria, causing bacteria that may spread to the kidneys.
4. Risk factors for cancer in diabetes
Individuals suffering from diabetes tend to demonstrate known risk factors for cancer (such as poor diet, older age, obesity, and physical inactivity). Furthermore, complications associated with diabetes such as inflammation, excessively high blood sugar levels, and excessively high insulin levels can increase the risk of cancer. Diabetes may double the risk of pancreas, liver, and endometrial cancer. It may also increase the risk of breast, bladder, and colorectal cancer to as much as 20 to 50 percent.
5. Treatment Options
Diabetic nephropathy can be diagnosed through a series of tests including urine tests, blood pressure, blood tests, biopsy, and kidney ultrasound.
It is important for patients with diabetes and kidney diseases such as diabetes and kidney failure or diabetic kidney disease to manage their blood pressure through low consumption of salt, regular exercises, abstaining from tobacco and alcohol, and losing excess weight. Doctors may recommend blood pressure drugs such as angiotensin-converting enzyme (ACE) inhibitors (including captopril and enalapril) and angiotensin receptor blockers to patients with diabetes and kidney diseases.
The doctor may recommend Dialysis or artificial kidney treatment in some cases. End-stage kidney failure involves the failure of kidneys to perform their routine functions properly. Dialysis involves the removal of wastes from the body through fluid introduced into the abdomen or shunting the blood of the patient through haemodialysis, a special machine that is effective to preserve water and salt in the body while removing the wastes.
In extreme circumstances, the doctor may recommend a kidney transplant. In such cases, a healthy donor kidney is contacted (from a relative or friend or someone who has died) to replace the function of the diseased or damaged kidneys.
Take away
Managing diabetes and kidney diseases can be extremely challenging for anyone. It is important for you to seek medical intervention at the earliest to avoid severe health complications.
Contact the Urethra Clinic to have a detailed consultation with Dr Vikram Shah Batra, a committed Reconstructive Urologist, Neuro urologist and Female Genitourinary Surgeon, now. Dr. Batra will compassionately listen to your concerns and suggest the best possible treatment to help you regain your health.