Can Diabetes Cause Chronic Kidney Disease?

Diabetic Nephropathy (kidney Disease)

What is diabetic nephropathy? Nephropathy means your kidneys are not working well. The final stage of nephropathy is called kidney failure, end-stage renal disease, or ESRD. Diabetes, both type 1 and type 2, is the most common cause of kidney disease. Type 1 is more likely to lead to ESRD. There are 5 stages of diabetic nephropathy. The final stage is ESRD. Progress from one stage to the next can take many years. What causes diabetic nephropathy? Both high blood pressure and high blood sugar damage the kidneys. As kidney disease gets worse, physical changes in the kidneys often lead to increased blood pressure. Uncontrolled high blood pressure can speed the progress toward ESRD. High blood sugar related to diabetes damages the kidney in several different ways. Mainly, it damages the blood vessels that filter the blood to make urine. What are the symptoms of diabetic nephropathy? Over years, as kidney disease develops, small amounts of the blood protein albumin begin to show in your urine. This first stage of chronic kidney disease is called moderately increased albuminuria or microalbuminuria. The kidneys are still able to filter waste during this stage. As the disease worsens larger amounts of albumin leak into the urine. This stage may be called severely increased albuminuria or macroalbuminuria. As the amount increases, the kidneys can’t cleanse the blood as well. Wastes are left in the blood. Blood pressure often rises as well. Overall, kidney damage rarely happens in the first 10 years of diabetes. Kidney failure usually happens 15 to 25 years after the first symptoms of diabetes. If you have had diabetes for more than 25 years without any signs of kidney failure, your risk of developing it decreases. How is diabetic nephropathy diagnosed? If you have diabetes, i Continue reading >>

Kidneys (nephropathy)

Kidney disease can happen to anyone but it is much more common in people with diabetes and people with high blood pressure. Kidney disease in diabetes develops very slowly, over many years. It is most common in people who have had the condition for over 20 years. About one in three people with diabetes might go on to develop kidney disease, although, as treatments improve, fewer people are affected. What is kidney disease? The kidneys regulate the amount of fluid and various salts in the body, helping to control blood pressure. They also release several hormones. Kidney disease (or nephropathy to give it its proper name) is when the kidneys start to fail. If the kidneys start to fail they cannot carry out their jobs so well. In the very early stages there are usually no symptoms and you may not feel unwell, this can mean there are changes in blood pressure and in the fluid balance of the body. This can lead to swelling, especially in the feet and ankles. As kidney disease progresses, the kidneys become less and less efficient and the person can become very ill. This happens as a result of the build up of waste products in the blood, which the body cannot get rid of. Kidney disease can be a very serious condition. Why are people with diabetes more at risk? Kidney disease is caused by damage to small blood vessels. This damage can cause the vessels to become leaky or, in some cases, to stop working, making the kidneys work less efficiently. Keeping blood glucose levels as near normal as possible can greatly reduce the risk of kidney disease developing as well as other diabetes complications. It is also very important to keep blood pressure controlled. How does my doctor check for kidney disease? As part of your annual health care review you should have a blood and urine t Continue reading >>

Diabetes Is The Leading Cause Of Chronic Kidney Disease

According to the Centers for Disease Control, over 17 million Americans have diabetes. Unfortunately, one-third does not realize they have the disease. Diabetes is the number one cause of chronic kidney disease (CKD). In 1999, almost 44% of patients who needed dialysis had diabetes as the underlying cause for their kidney disease. The numbers continue to rise today. How diabetes damages the kidneys Diabetes is a disease that affects the body’s ability to produce or use insulin. When the body turns the food eaten into energy (also called sugar or glucose), insulin is used to move this sugar into the cells. If someone produces little or no insulin, or if the body cannot use the insulin (insulin resistant), the sugar remains in the bloodstream instead of going into the cells. Over time, high levels of sugar in the blood damage tiny blood vessels throughout the body including the filters of the kidneys. As more damage occurs to the kidneys, more fluid and waste remain in the bloodstream instead of being removed. Symptoms of diabetes The American Diabetes Association lists the symptoms of diabetes as: Frequent urination Excessive thirst Extreme hunger Unusual weight loss Excessive fatigue Irritability Blurry vision Lack of an early diagnosis compounds the problem Type 1 diabetes (also known as juvenile diabetes or insulin-dependent diabetes) is typically diagnosed early because its symptoms are severe and rapid. A treatment plan can then be put in place and continued. Unfortunately, Type 2 diabetes often goes undiagnosed for many years because early symptoms are not severe. It is estimated that by the time someone is diagnosed with Type 2 diabetes, the disease has been present for four to seven years. Since diabetes may have been present for some time, the chances for kidn Continue reading >>

Chronic Kidney Disease In Diabetes

Article Outline Jump to Section Introduction Diseases of the kidney are a common finding in people with diabetes, with up to half demonstrating signs of kidney damage in their lifetime (1, 2, 3). Diabetes is the leading cause of kidney disease in Canada (4). Kidney disease can be a particularly devastating complication, as it is associated with significant reductions in both length and quality of life (5, 6). A variety of forms of kidney disease can be seen in people with diabetes, including diabetic nephropathy, ischemic damage related to vascular disease and hypertension, as well as other renal diseases that are unrelated to diabetes (Figure 1) (7, 8). In this chapter, we will discuss how to screen for and diagnose chronic kidney disease (CKD) in people with diabetes, how to treat them with an aim to slow progression of CKD and discuss the impact of CKD on other aspects of diabetes management. Jump to Section Diabetic Nephropathy The classic description of diabetic nephropathy is of a progressive increase in proteinuria in people with longstanding diabetes followed by declining function that eventually can lead to end stage renal disease (ESRD) (Figure 2) (1, 9, 10). Key risk factors for diabetic nephropathy include long duration of diabetes, poor glycemic control, hypertension, male gender, obesity and cigarette smoking. Many of these factors are modifiable. The earliest stage of diabetic nephropathy is hyperfiltration, where the glomerular filtration rate (GFR) is significantly higher than normal. Identification of hyperfiltration is not clinically useful, as it is difficult to determine from routine testing. Persistent albuminuria is considered the earliest clinical sign of diabetic nephropathy (Table 1). Initially, small amounts of albumin are leaked, below the de Continue reading >>

Renal Failure

Renal failure, especially CRF (Chronic renal failure), is a fairly common condition in older cats and dogs. The kidneys become less and less efficient at removing wastes[1] from the blood. CRF can sometimes be mistaken for diabetes, since polyuria and polydipsia can occur in both; this may lead to incorrect treatment and progression of the renal failure[2][3]. Diabetes can affect all bodily organs. Many humans with long-term diabetes have some problems relating to the kidneys, including diabetic nephropathy. There are many people who are renal dialysis patients and on renal transplant lists who are also diabetes patients. When CRF occurs in a diabetic pet, things can get tricky, since diabetes and CRF can complicate each other: prolonged hyperglycemia can lead to diabetic nephropathy. CRF can make it harder to regulate blood glucose levels. Insulin is metabolized mainly through the liver and kidneys[5][6]. The term used in references such as Physicians' Desk Reference and other medication information is reduced renal clearance, for the kidneys, reduced hepatic clearance for the liver. When the system processes insulin (and other medications) at a slower than normal rate, they remain in the system longer[7]. In the case of insulin, a previously acceptable dosage may lead to hypoglycemia, because it takes longer for the kidneys and/or liver to render it useless. Renal problems seem to affect the clearance of insulin more than disorders of the liver[8]. CRF and high blood pressure are both possible complications of diabetes, and of each other. See blindness. Continue reading >>

Who´s At Risk For Chronic Kidney Disease

15% of adults in the US have chronic kidney disease (CKD)—though most don’t realize it. One challenge in detecting CKD is that there are virtually no kidney disease symptoms until later stages, when kidney damage has already occurred. Know your risk factors, learn the symptoms and get tested for CKD—especially if you have one of the known causes, like diabetes or high blood pressure. Learn more now Diabetes can impact blood circulation within the glomerulus, a part of the kidney’s blood-filtering system. People with diabetes may also have the following risk factors: High blood pressure Poor glucose control A family history of kidney disease How kidney disease progresses with diabetes Type 1 diabetes Changes in kidney function may begin within 2-5 years after diagnosis of diabetes. Within 10-30 years of being diagnosed with type 1 diabetes, 30%-40% of people develop late stage kidney disease. Type 2 diabetes Kidney disease in type 2 diabetes follows a time line that is similar to type 1 diabetes, but type 2 diabetes usually occurs later in life. What you can do to prevent kidney disease with high blood pressure It’s recommended that you keep your blood pressure below 140/90. Here are ways you can keep your blood pressure under control: Eat healthy Exercise Reduce stress Don’t smoke Talk to your doctor about medication Lifestyle changes can help prevent PKD—and CKD—from progressing. Here are some things you can do: Drink plain water. Avoid caffeine. Get 7-8 hours of sleep per night. Maintain a healthy weight. Reduce stress. Keep blood pressure levels under control. Treat bladder or kidney infections as soon as possible. Keep in mind that not everyone with PKD will develop kidney failure, but certain people are at an increased risk: Men People with high blo Continue reading >>

Chronic Kidney Disease And Diabetic Patients At Risk Of Mouth Complications Without Proper Care

People who have Chronic Kidney Disease and/or Diabetes know that the diseases can unfortunately harm their eyes, nerves, heart and other important systems in the body. Many, however, do not know that Chronic Kidney Disease and Diabetes can also cause problems in their mouth. The side effects can be devastating to your overall dental health and your teeth specifically. Do you know why? Well, it is because Diabetes and Chronic Kidney Disease can weaken the immune system which is the body's main defense against bacterial infections which can occur in the mouth. Recommended Reading: Natural Ways Chronic Kidney Disease Patients Improve Oral Health And Increase Chances For Transplant Did you know that those with Chronic Kidney Disease and/or Diabetes are at an elevated risk for Periodontal Disease (an infection of the gum and bone that hold the teeth in place)? Periodontal disease can lead to painful chewing difficulties, tooth decay, and even tooth loss. Another complication such as Dry Mouth can cause soreness, ulcers, infections, and tooth decay. Dry Mouth is often found in Chronic Kidney Disease, Diabetes and even more frequently, Dialysis patients. Recommended Reading: Bad Breath In Chronic Kidney Disease Patients Can Be A Sign For Need Of Immediate Medical Attention People with Chronic Kidney Disease and Diabetes additionally face a higher risk of gum inflammation (swelling) which includes Gingivitis (Gum Disease). This is due to blood vessel complications which may thicken and slow the flow of nutrients to and waste products from body tissues, including the mouth and reduce the body's ability to fight infections. Recommended Reading: Reevaluating Chronic Kidney Disease Patients' Weight Increases Between Dialysis Treatments If you have a burning sensation in your mouth Continue reading >>

Chronic Kidney Disease

Overview Chronic kidney disease (CKD) is a long-term condition where the kidneys don't work as well as they should. It's a common condition often associated with getting older. Anyone can get it, although it's more common in black people and people of south Asian origin. CKD can get gradually worse over time and eventually the kidneys may stop working altogether, but this is uncommon. Many people with kidney disease are able to live long, largely normal lives. Symptoms of CKD There are usually no symptoms of kidney disease in the early stages. It may only be picked up if blood or urine tests carried out for another reason detect a possible problem with your kidneys. When it reaches a more advanced stage, symptoms can include: See your GP if you have persistent or worrying symptoms that you think could be caused by kidney disease. Read more about the symptoms of CKD. Causes of CKD Kidney disease is usually caused by other conditions that put a strain on the kidneys. Often it's the result of a combination of different problems. CKD can be caused by: high blood pressure – over time, this can put strain on the small blood vessels in the kidneys and stop the kidneys working properly diabetes – too much glucose in your blood can damage the tiny filters in the kidneys high cholesterol – this can cause a build-up of fatty deposits in the blood vessels supplying your kidneys, which can make it harder for them to work properly polycystic kidney disease – an inherited condition where growths called cysts develop in the kidneys blockages in the flow of urine – for example, from recurrent kidney stones or an enlarged prostate long-term, regular use of certain medicines – such as lithium and non-steroidal anti-inflammatory drugs (NSAIDs) You can help prevent CKD by making Continue reading >>

Insulin Resistance And Chronic Kidney Disease In Patients With Type 1 Diabetes Mellitus

Background and Aims. Diabetes mellitus (DM) is a chronic disease which can evolve towards devastating micro- and macrovascular complications. DM is the most frequent cause of chronic kidney disease (CKD). Insulin resistance plays an important role in the natural history of type 1 diabetes. The purpose of the study was to determine the prevalence of CKD in T1DM and the correlation with insulin resistance (IR) in patients with CKD. Materials and Methods. The study was conducted over a period of three years (2010–2013) and included patients with DM registered in the Clinical Centre of Diabetes, Nutrition and Metabolic Diseases of Dolj county. The study design was an epidemiological, transversal, noninterventional type. Finally, the study group included 200 subjects with type 1 DM. Insulin resistance (IR) was estimated by eGDR. The subjects with eGDR ≤ 7.5 mg/kg/min were considered with insulin resistance. Results. CKD was found in 44% of the patients. Analyzing statistically the presence of CKD, we found highly significant differences between patients with CKD and those without CKD regarding age and sex of the patients, the duration of diabetes, glycosylated hemoglobin (HbA1c), the estimated glucose disposal rate (eGDR), and the presence of hypertension, dyslipidemia, and hyperuricaemia. In patients with CKD, age and diabetes duration are significantly higher than in those who do not have this complication. CKD is more frequent in males than in females (50.9% men versus 34.5% women, ). From the elements of metabolic syndrome, high blood pressure, hyperuricemia, and dyslipidemia are significantly increased in diabetic patients with CKD. eGDR value (expressed as mg·kg−1·min−1) is lower in patients with CKD than in those without CKD (15.92 versus 6.42, ) indicating Continue reading >>

Management Of Diabetes Mellitus In Individuals With Chronic Kidney Disease: Therapeutic Perspectives And Glycemic Control

The purpose of this study was to evaluate the therapeutic options for diabetes treatment and their potential side effects, in addition to analyzing the risks and benefits of tight glycemic control in patients with diabetic kidney disease. For this review, a search was performed using several pre-defined keyword combinations and their equivalents: “diabetes kidney disease” and “renal failure” in combination with “diabetes treatment” and “oral antidiabetic drugs” or “oral hypoglycemic agents.” The search was performed in PubMed, Endocrine Abstracts and the Cochrane Library from January 1980 up to January 2015. Diabetes treatment in patients with diabetic kidney disease is challenging, in part because of progression of renal failure-related changes in insulin signaling, glucose transport and metabolism, favoring both hyperglycemic peaks and hypoglycemia. Additionally, the decline in renal function impairs the clearance and metabolism of antidiabetic agents and insulin, frequently requiring reassessment of prescriptions. The management of hyperglycemia in patients with diabetic kidney disease is even more difficult, requiring adjustment of antidiabetic agents and insulin doses. The health team responsible for the follow-up of these patients should be vigilant and prepared to make such changes; however, unfortunately, there are few guidelines addressing the nuances of the management of this specific population. Key words: Type 2 Diabetes Mellitus; Chronic Kidney Disease, Diabetic Kidney Disease; Renal Failure; Diabetes Treatment; Oral Antidiabetic Drugs Continue reading >>

Diabetic Kidney Disease

What is diabetic kidney disease? Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1 The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy. When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. What are other names for diabetic kidney disease? Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. How does diabetes cause kidney disease? High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease. What increases my chances of developing diabetic kidney disease? Having diabetes for a longer time increases the chances that you will have kidney damage. If you have diabetes, you are more likely to develop kidney disease if your blood glucose is too high blood pressure is too high African Americans, American Indians, and Hispanics/Latinos develop diabetes, kidney disease, and kidney failure at a higher rate than Caucasians. You are also more likely to develop kidney disease if you have diabetes and smoke don’t follow your di Continue reading >>

Diabetes&its Link To Kidney Disease

Online Health Chat with Dr. Betul Hatipoglu and Dr. George Thomas Introduction Cleveland_Clinic_Host: Research shows that diabetes is the leading cause of kidney disease. In honor of World Kidney Day on March 10, 2011, the Glickman Urological & Kidney Institute and the Endocrinology & Metabolism Institute invite you to an online chat about diabetes and its link to kidney function. Join endocrinologist Betul Hatipoglu, MD, and nephrologist George Thomas, MD, online for answers to your questions concerning diabetes and kidney disease. Both Cleveland Clinic’s Glickman Urological & Kidney Institute and Endocrinology & Metabolism Institute are ranked in the top 10 nationally by U.S. News & World Report. Dr. Betul Hatipoglu is a staff member in the Department of Endocrinology, Diabetes and Metabolism at Cleveland Clinic's main campus, having accepted that appointment in 2008. Prior to that appointment, she was an assistant professor of medicine and medical director for the pancreas and islet cell transplant program at the University of Illinois at Chicago for nearly eight years. Her clinical interests include diabetes, thyroid disease in woman, pituitary and adrenal disorders, and alternative medicine. Dr. Hatipoglu received her medical degree from Istanbul Medical School. She completed an internal medicine residency and chief residency at Michael Reese-University of Illinois at Chicago, and an endocrinology fellowship at the University of Illinois at Chicago. Dr. Hatipoglu speaks three languages -- English, Turkish and French -- and is board-certified in internal medicine, as well as endocrinology, diabetes and metabolism. Dr. George Thomasis a staff member in the Department of Nephrology and Hypertension of the Glickman Urological & Kidney Institute at Cleveland Clinic. H Continue reading >>

Kidney Failure (long-term) In Dogs

Chronic Renal Failure in Dogs Nine in every 1,000 dogs that are examined suffer from chronic renal disease. And while dogs of any age can be diagnosed with the kidney disease, it is more commonly seen in older dogs. Failure of the kidney -- which among other things regulates blood pressure, blood sugar, blood volume, water composition in the blood, and pH levels, and produces red blood cells and certain hormones -- can take so place so slowly, that by the time the symptoms have become obvious, it may be too late to treat the condition effectively. Often, the kidney will find ways to compensate as it loses functionality over the course of months, or even years. While chronic renal failure cannot be reversed or cured, treatment and management aimed at reducing the contributing factors and symptoms can slow its progression. Chronic renal failure can affect both dogs and cats. If you would like to learn more about how this disease affects cats, please visit this page in the PetMD health library. Symptoms and Types of Kidney Failure in Dogs Symptoms often occur gradually over an extended petriod of time. In addition, symptoms may vary and not all of those listed below will be seen in every dog: Vomiting Lethargy Depression Weight loss Lack of appetite (anorexia) Acute blindness Seizures and comas Causes of Kidney Failure in Dogs Causes of kidney failure can include kidney disease, urinary blockage (obstruction of the urinary tract or of the ureters), certain prescription medications, lymphoma, diabetes mellitus, and genetic (hereditary) factors. The following breeds are prone to chronic renal failure: Diagnosis of Kidney Failure in Dogs Your dog will undergo a complete blood profile, including a chemical blood profile, a complete blood count, and a urinalysis. Dogs with chro Continue reading >>

The Link Between Type 2 Diabetes And Kidney Disease: What You Should Know

This is a guest post by Kristen Nichols Heitman, MPH, an epidemiologist in the Rickettsial Zoonoses Branch in the Division of Vector-Borne Diseases in the National Center for Emerging Zoonotic and Infectious Diseases at the Centers for Disease Control and Prevention (CDC). She received a Master of Public Health (MPH) with a concentration in epidemiology from Georgia State University. Each of your kidneys is about the size of a computer mouse and made up of millions of tiny filters called nephrons. Too much glucose, also called sugar, in your blood from diabetes damages your kidneys’ nephrons. If the nephrons are damaged, a protein called albumin, which you need to stay healthy, leaks out of your blood and into your urine. Damaged kidneys do not do a good job of filtering wastes and extra fluid from your blood. The waste and extra fluid build up in your blood and make you sick. This is the condition known as chronic kidney disease (CKD). Diabetes is the most common cause of CKD in the United States and approximately one in three adults with diabetes has CKD. Also, the number of young people with type 2 diabetes is increasing; having diabetes for a longer time means more time to develop diabetes complications, including CKD. What’s even more alarming is CKD often develops slowly and with few symptoms, so many people don’t even realize they’re sick until the disease is advanced. If not treated, CKD gets worse and can lead to kidney failure, known as end-stage renal disease (ESRD), or stage 5 CKD. A person with ESRD will need regular dialysis or a kidney transplant to survive. Diabetes is the most common cause of ESRD, accounting for nearly 44 percent of new cases. The only way to find out whether you have CKD is through specific blood and urine tests. Your doctor w Continue reading >>

High Blood Pressure And Diabetic Kidney Disease

High blood pressure (hypertension) is one of the principal causes of diabetic kidney disease and kidney failure. When blood pressure is high, there is a large amount of tension inside the blood vessels that leads to damage. These vessels may close off completely which can cause a heart attack, stroke, or kidney failure. High blood sugar and high cholesterol can also damage blood vessels. Thus people with diabetes who also have hypertension are at especially high risk for blood vessel damage. It usually takes years for blood vessels to completely close off and damage to blood vessels can be slowed down or reversed with treatment. Diagnosis Diagnosis of high blood pressure can only be done by having your blood pressure measured by a person trained in taking blood pressures. Usually, there are no symptoms that can tell you that you have high blood pressure. In diabetic patients the blood pressure is considered high if it is greater than 130/80. Your blood pressure should be measured on multiple occasions as blood pressures vary normally throughout the day and it is normal to have occasional high pressures. Blood pressure should be taken after you have rested for 5 minutes and may be taken sitting or standing. Your healthcare providers may ask you to check your blood pressure at home and record the readings as part of your blood pressure management. Treatment There are multiple ways to control your blood pressure. The first step is lifestyle changes. Most patients will also need one or several medications to achieve good blood pressure control. Lifestyle Changes Your diet and lifestyle can directly affect blood pressure. For example, too much salt, alcohol, or caffeine intake leads to your body increase your blood pressure. Your weight also affects your blood pressure. Incr Continue reading >>