One of the more common long-term complications of diabetes is diabetic renal disease ("renal" refers to the kidneys). Also known as diabetic nephropathy, this condition is a result of direct vascular abnormalities that accompany diabetes. Furthermore, diabetes mellitus is the main cause of end-stage renal disease (ESRD), the most advanced stage of kidney disease.
Stages of Chronic Kidney Disease (CKD)
These are some of the progressive stages chronic of kidney disease.
- Chronic renal insufficiency
Even in the first stage of kidney disease, the organ suffers damage. While there is impaired kidney function, during this stage there are only minimal effects to the entire body.
- Chronic renal failure
In stage two of the disease, damage to the kidneys has progressed to a level that causes problems throughout the body. One such problem is an increase in the amount of waste products in the blood such as urea, creatinine and phosphate. When the body functions normally, the kidneys are able to remove these waste products. Other effects of chronic renal failure include anemia, bone disease, acidosis, and salt and fluid retention. Most patients with chronic renal failure progress to the final or end-stage of kidney disease.
- End-stage renal disease (ESRD)
By the time a patient reaches end-stage renal disease, the condition and its effects are generally irreversible. To sustain life, the patient requires renal replacement therapy, which includes dialysis or a kidney transplant.
Why does diabetes increase the risk for kidney disease?
High blood sugar can overwork the kidneys, which over time damage them. After many years, they start to leak small amounts of protein (albumin) into the urine, which indicates that the kidneys are damaged. Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood sugar control, and blood pressure. The better a person keeps diabetes and blood pressure under control, the lower the chance of getting kidney disease.
How are cardiovascular disease (CVD) and kidney disease related?
Chronic kidney disease can lead to cardiovascular disease (CVD). Conversely, CVD can lead to kidney disease, so the two diseases are strongly intertwined. According to studies, CVD begins to have an effect on the body as early as the first stage of kidney disease, and most people with ESRD die as a result of cardiovascular complications.
Risks that are often associated with kidney disease also contribute to the development of cardiovascular disease.
- High blood pressure (hypertension)
- High LDL ("bad") cholesterol
- Low HDL ("good") cholesterol
- Physical Activity
- Older age
What should I do if I have diabetes?
Many of the risk factors for kidney disease and CVD are treatable. If you have diabetes, take these steps:
- Keep your blood sugar levels in the normal range.
- Control your blood pressure.
- Manage your weight.
- Work closely with your health care team to ensure your urine albumin levels are being monitored. (The American Diabetes Association suggests that people with type 2 diabetes should be screened for urine albumin levels at the time of diagnosis and once a year thereafter.)
Learn about other habits you can establish to get healthy. Visit our Cardiovascular Media Library to view animations and illustrations of conditions and healthy living related to kidney disease.
This content was last reviewed on 7/5/2012.