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How Does Diabetes Lead To Kidney Disease?

Kidney Disease Of Diabetes

Kidney Disease Of Diabetes

Kidney Disease of Diabetes Facts* *Kidney Disease of Diabetes Facts Medically Edited by: Melissa Conrad Stöppler, MD Type 2 Diabetes Diagnosis, Treatment, Medication Medical Author: Melissa Conrad Stoppler, MD Medical Editor: Ruchi Mathur, MD, FRCP(C) Proper nutrition is essential for anyone living with diabetes. Control of blood glucose levels is only one goal of a healthy eating plan for people with diabetes. A diet for those with diabetes should also help achieve and maintain a normal body weight as well as prevent heart and vascular disease, which are frequent complications of diabetes. There is no prescribed diet plan for those with diabetes. Rather, eating plans are tailored to fit an individual's needs, schedules, and eating habits. A diabetes diet plan must also be balanced with the intake of insulin and oral diabetes medications. In general, the principles of a healthy diabetes diet are the same for everyone. Consumption of a variety of foods including whole grains, fruits, non-fat dairy products, beans, and lean meats or vegetarian substitutes, poultry and fish is recommended to achieve a healthy diet. Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of chronic kidney disease (CKD). Diabetes is the most common cause of kidney failure, accounting for nearly 44 percent of new cases. Even when diabetes is controlled, the disease can lead to chronic kidney disease and kidney failure. Most people with diabetes do not develop chronic kidney disease that is severe enough to progress to kidney failure. Nearly 24 million people in the United States have diabetes, and nearly 200,000 people are living with kidney failure a Continue reading >>

Diabetic Nephropathy - Topic Overview

Diabetic Nephropathy - Topic Overview

What is diabetic nephropathy? Nephropathy means kidney disease or damage. Diabetic nephropathy is damage to your kidneys caused by diabetes. In severe cases it can lead to kidney failure. But not everyone with diabetes has kidney damage. What causes diabetic nephropathy? The kidneys have many tiny blood vessels that filter waste from your blood. High blood sugar from diabetes can destroy these blood vessels. Over time, the kidney isn't able to do its job as well. Later it may stop working completely. This is called kidney failure. Certain things make you more likely to get diabetic nephropathy. If you also have high blood pressure or high cholesterol, or if you smoke, your risk is higher. Also, Native Americans, African Americans, and Hispanics (especially Mexican Americans) have a higher risk. What are the symptoms? There are no symptoms in the early stages. So it's important to have regular urine tests to find kidney damage early. Sometimes early kidney damage can be reversed. As your kidneys are less able to do their job, you may notice swelling in your body, most often in your feet and legs. How is diabetic nephropathy diagnosed? The problem is diagnosed using simple tests that check for a protein called albumin in the urine. Urine doesn't usually contain protein. But in the early stages of kidney damage-before you have any symptoms-some protein may be found in your urine, because your kidneys aren't able to filter it out the way they should. Finding kidney damage early can keep it from getting worse. So it's important for people with diabetes to have regular testing, usually every year. How is it treated? The main treatment is medicine to lower your blood pressure and prevent or slow the damage to your kidneys. These medicines include: Angiotensin-converting enzyme Continue reading >>

Diabetic Kidney Disease: Pathophysiology And Therapeutic Targets

Diabetic Kidney Disease: Pathophysiology And Therapeutic Targets

Journal of Diabetes Research Volume 2015 (2015), Article ID 697010, 16 pages Division of Nephrology, Johns Hopkins University, 1830 E. Monument Street, Suite 416, Baltimore, MD 21287, USA Academic Editor: Christian Wadsack Copyright © 2015 Stephanie Toth-Manikowski and Mohamed G. Atta. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Diabetes is a worldwide epidemic that has led to a rise in diabetic kidney disease (DKD). Over the past two decades, there has been significant clarification of the various pathways implicated in the pathogenesis of DKD. Nonetheless, very little has changed in the way clinicians manage patients with this disorder. Indeed, treatment is primarily centered on controlling hyperglycemia and hypertension and inhibiting the renin-angiotensin system. The purpose of this review is to describe the current understanding of how the hemodynamic, metabolic, inflammatory, and alternative pathways are all entangled in pathogenesis of DKD and detail the various therapeutic targets that may one day play a role in quelling this epidemic. 1. Introduction Diabetes has long been a growing epidemic in the United States (US) and around the world. In 2011, there were 20.8 million people aged 18 years and older who carried a diagnosis of diabetes in the US alone [1]. The number of adults aged 18–79 in the US that were newly diagnosed with diabetes has more than tripled from 493,000 in 1980 to over 1.5 million in 2011 [2]. The increased prevalence of diabetes has also led to an increase in the number of macro- and microvascular complications of diabetes such as coronary heart disease, stro Continue reading >>

Diabetic Kidney Disease: Chronic Kidney Disease And Diabetes

Diabetic Kidney Disease: Chronic Kidney Disease And Diabetes

The traditional clinical hallmark of chronic kidney disease (CKD) in diabetic microvascular disease of the kidney has been overt proteinuria; once manifest, diabetic nephropathy was considered apparent. The term “nephropathy” classically was associated with foamy urine, hypertension, and renal edema formation attributable to sodium retention and fostered by impaired kidney function and hyperglycemia. In fact, the simultaneous diagnosis of the triad of proteinuria, high blood pressure, and edema actually indicated that “the horse was out of the barn”; diabetic kidney disease was already present and likely had been for years. To emphasize the impact of diabetes on the renal parenchyma at much earlier stages of the disease, the National Kidney Foundation's Kidney Dialysis Outcomes Quality Initiative Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease now promote the term “diabetic kidney disease” (DKD) as a nonproteinuric designation of CKD in type 1 or type 2 diabetes.1 DKD will occur in 30–40% of people with diabetes, and one-third of these individuals may develop kidney failure. DKD occurs in patients with either type 1 or type 2 diabetes; however, patients with type 2 diabetes often present with a mixed picture of atherosclerotic renal changes coincident with diabetic histological findings. Judgment of whether hypertension or diabetes is the dominant lesion, in the absence of a kidney biopsy, is typically predicated on whether a renal ultrasonogram depicts small or normal-to-large kidneys. In the former instance, hypertensive angiosclerosis is considered causative, whereas the latter circumstance coincides with DKD, irrespective of the level of proteinuria. Importantly, when microalbuminuria, macroalb Continue reading >>

Diabetes Is The Leading Cause Of Chronic Kidney Disease

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 >>

Kidney Damage With Diabetes

Kidney Damage With Diabetes

The kidneys are the body's filtering system. They pull waste and extra water from the blood and take it out of the body as urine. The filtering parts of the kidneys are called nephrons. Nephrons have many small blood vessels in them. High blood sugar levels and uncontrolled high blood pressure can damage these small blood vessels. Damage to the nephrons is called nephropathy. In the early stages of nephropathy, the body doesn't give any warning signs that the damage is happening. Fortunately, a quick urine test, called a microalbuminuria test, can find early signs of nephropathy. Stages of Kidney Disease Diabetes can lead to changes in the kidneys that happen in stages. In the early stages, stages 1 through 3, the kidneys are able to make up for the damage and there aren't any obvious signs that the damage is happening. When enough damage occurs, in stages 4 and 5, the kidneys lose their ability to filter and cleanse the blood. Stage 1: In this very early stage, the blood flow through the kidneys increases and the kidneys get slightly larger. Good blood pressure and blood sugar control are very important at this stage to help prevent any more changes. Stage 2: The kidneys start showing damage in stage 2, as small amounts of protein (albumin) begin to leak into the urine. The kidneys will normally try to keep from filtering protein into the urine because protein is such an important building block for the body. Albumin in the urine in this small amount (200 micrograms or less per milligram of urine) is found by a test called the microalbumin urine test, done at the lab. At this stage, treatment includes quitting all tobacco products, controlling high blood pressure, keeping blood sugar levels as close to normal as possible, and using an ACE inhibitor or similar drug. Doi Continue reading >>

Diabetic Kidney Disease

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 And Kidney Problems

Diabetes And Kidney Problems

Diabetes can lead to a variety of serious complications, including kidney problems. More than 100,000 new cases of kidney failure are diagnosed in the United States annually. Kidney failure occurs when the kidneys are unable to get rid of the body’s waste products; it is considered the final stage in chronic kidney disease (CKD). Diabetes causes 44 percent of kidney failure cases and, even with good diabetes management, you can still develop CKD. But it is not an automatic complication: The National Institute of Diabetes and Digestive and Kidney Diseases reports that almost 24 million people in the United States have diabetes, and only about 180,000 have kidney failure. How Diabetes Leads to Kidney Problems The connection between diabetes and kidney problems starts when small blood vessels become damaged from diabetes. Injury to blood vessels in the kidneys prevents these organs from functioning properly. As a result, they do not clean the blood efficiently and protein and wastes accumulate. Your body also retains more salt and water, causing you to swell. The nerves in your body can also be injured by diabetes, which leads to problems emptying your bladder. Pressure from a full bladder can, in turn, hurt your kidneys. When urine stays in the bladder for a long time, infections can develop. Kidney problems related to diabetes generally develop over several years. During this time, people who develop kidney problems will have small amounts of the blood protein albumin leak into their urine. Your kidney’s filtration function typically stays normal during this stage of CKD, which is called microalbuminuria. But as CKD progresses, more albumin leaks into your urine and your kidney's filtering function starts to fail. Along with this comes a rise in blood pressure. Howev Continue reading >>

High Blood Pressure And Diabetic Kidney Disease

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 >>

Diabetic Nephropathy - Kidney Disease

Diabetic Nephropathy - Kidney Disease

Tweet Kidney disease amongst diabetics is commonly called diabetic nephropathy. Statistically, around 40% of people with diabetes develop nephropathy but it is possible to prevent or delay through control of both blood glucose and blood pressure levels. Diabetes affects the arteries of the body and as the kidneys filter blood from many arteries, kidney problems are a particular risk for people with diabetes. What is diabetic nephropathy? Nephropathy is a general term for the deterioration of proper functioning in the kidneys. At an advanced level, this is called end-stage renal disease or ESRD. ESRD often stems from diabetes, with diabetes causing just under half of all cases. Diabetic nephropathy can affect people with both type 1 and type 2 diabetes. Diabetic nephropathy is divided into five stages of deterioration, with the final one being ESRD. It commonly takes over 20 years for patients to reach stage 5. Symptoms of kidney disease The symptoms of diabetic nephropathy tend to become apparent once the condition has reached the later stages. Typically the following symptoms may start to be noticed around stage four of its progression: Swelling of the ankles, feet, lower legs or hands caused by retention of water Darker urine, caused by blood in the urine Becoming short of breath, when climbing the stairs for instance Tiredness as a result of a lack of oxygen in the blood Nausea or vomiting To help catch nephropathy before the later stages develop, people with diabetes should be screened for kidney complications once a year. The screening test involves a simple urine sample which is tested to detect whether protein is present in the urine. Read more on kidney disease screening What are the causes of diabetic nephropathy? Statistics show that development of kidney dise Continue reading >>

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body. The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life. Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans. With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood. Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that h Continue reading >>

The Link Between Diabetes & Kidney Disease

The Link Between Diabetes & Kidney Disease

How can diabetes affect the kidneys? People with diabetes need to watch their glucose levels and blood pressure, as over time high blood glucose levels and blood pressure can damage the tiny blood vessels in the filters of the kidneys. At this early stage, this damage causes small amounts of protein to be passed in the urine which is known as microalbumin. In a later stage, so much protein can be lost from the blood that water moves into the body tissues and causes swelling. After a number of years, the kidney filters can fail completely. Wouldn't I know if I had kidney damage? Not necessarily - there is actually a high chance you wouldn't know at all. There are no warning signs for chronic kidney disease and you could lose up to 90 per cent of your kidney function before you felt unwell. How can I find out if my kidneys are affected? Chronic kidney disease is common in people who have diabetes. The only way to know if you are affected is to have a yearly kidney health check by your doctor or diabetes specialist. The doctor or specialist will order a blood and urine test and will also check your blood pressure to determine if you have any signs of kidney damage. Although there is no cure for chronic kidney disease, early detection and treatment is extremely important to slow or halt the progression of the disease. If chronic kidney disease is not detected and treated early, kidney function may continue to worsen, progressing to end stage kidney disease. In order to survive, people with end stage kidney disease may need to have dialysis or a kidney transplant. Kidney disease can also worsen other serious diabetes complications such as eye disease, nerve damage and cardiovascular disease. For further information about your risk of developing chronic kidney disease talk to Continue reading >>

Diabetic Nephropathy

Diabetic Nephropathy

Definition and Causes Diabetic nephropathy (DN) is typically defined by macroalbuminuria—that is, a urinary albumin excretion of more than 300 mg in a 24-hour collection—or macroalbuminuria and abnormal renal function as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filtration rate (GFR). Clinically, diabetic nephropathy is characterized by a progressive increase in proteinuria and decline in GFR, hypertension, and a high risk of cardiovascular morbidity and mortality. Prevalence and Risk Factors Diabetes has become the primary cause of end-stage renal disease (ESRD) in the United States, and the incidence of type 2 diabetes mellitus continues to grow in the United States and worldwide. Approximately 44% of new patients entering dialysis in the United States are diabetics. Early diagnosis of diabetes and early intervention are critical in preventing the normal progression to renal failure seen in many type 1 and a significant percentage of type 2 diabetics. In the United States, approximately 20.8 million people, or 7.0% of the population, are estimated to have diabetes, with a growing incidence. Roughly one third of this population, 6.2 million, is estimated to be undiagnosed with type 2 diabetes. The prevalence of diabetes is higher in certain racial and ethnic groups, affecting approximately 13% of African Americans, 9.5% of Hispanics, and 15% of Native Americans, primarily with type 2 diabetes.1, 2 Approximately 20% to 30% of all diabetics will develop evidence of nephropathy, although a higher percentage of type 1 patients progress to ESRD. Pathophysiology and Natural History The common progression from microalbuminuria to overt nephropathy has led many to consider microalbuminuria to define early or incipient Continue reading >>

Kidney Disease

Kidney Disease

Kidney disease – known as nephropathy – is a serious complication associated with long-term diabetes. Over the years, high blood glucose (sugar) levels and high blood pressure can damage the kidneys and prevent them from functioning properly or even cause them to fail completely. Diseases of the kidney are common in people with diabetes. In fact, up to 50% of people with diabetes demonstrate signs of kidney damage in their lifetime, but good diabetes management and regular screening can prevent or delay the loss of kidney function. What do the kidneys do? The kidneys are two bean-shaped organs located just below the ribs, near the back. They filter the blood, removing waste through the urine. The kidneys also regulate the amount of fluid and salts in the body and are important in controlling blood pressure. How does diabetes affect the kidneys? Diabetes is the leading cause of kidney disease in Canada. Over the long term, high blood glucose (sugar) levels damage tiny blood vessels in the kidneys, impairing their ability to filter the blood properly. As a result, a type of protein called "albumin" spills into the urine instead of being processed into the blood stream. Tiny amounts of protein in the urine is called microalbuminuria; as kidney disease progresses, more protein is found in the urine, a condition called proteinuria. Without treatment, the kidneys will eventually fail (this is known as "end-stage renal failure") and dialysis or a kidney transplant will be required. Diabetes can also affect kidneys by damaging the nerves that tell you when your bladder is full. The pressure from a full bladder can damage the kidneys. As well, if urine remains in the bladder for a long time, it can increase your risk of developing a urinary tract infection, which can spread Continue reading >>

Kidney Disease Of Diabetes

Kidney Disease Of Diabetes

Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of kidney disease, also known as nephropathy. Diabetes is the most common cause of kidney failure, accounting for nearly 45 percent of new cases. Even when diabetes is controlled, the disease can lead to nephropathy and kidney failure. Most people with diabetes do not develop nephropathy that is severe enough to cause kidney failure. About 18 million people in the United States have diabetes, and more than 150,000 people are living with kidney failure as a result of diabetes. People with kidney failure undergo either dialysis, which substitutes for some of the filtering functions of the kidneys, or transplantation to receive a healthy donor kidney. Most U.S. citizens who develop kidney failure are eligible for federally funded care. In 2003, care for patients with kidney failure cost the Nation more than $27 billion. African Americans, American Indians, and Hispanics/Latinos develop diabetes, nephropathy, and kidney failure at rates higher than Caucasions. Scientists have not been able to explain these higher rates. Nor can they explain fully the interplay of factors leading to diabetic nephropathy—factors including heredity, diet, and other medical conditions, such as high blood pressure. They have found that high blood pressure and high levels of blood glucose increase the risk that a person with diabetes will progress to kidney failure. There are two types of diabetes. In both types, the body does not properly process and use food. The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body’s cells. To enter cells, Continue reading >>

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