How Does Diabetes Affect the Kidneys?

Diabetes is a chronic disorder where the body fails to metabolise glucose produced from other metabolic processes, causing an increase in circulating glucose in the bloodstream. This occurs primarily because of failure in the synthesis and utilisation of the insulin hormone secreted from the beta cells of the pancreas. Insulin is responsible for initiating the body cells to absorb glucose from the blood and use it for different cellular functions. One of the primary organs affected is the kidney. The kidneys are made up of many tiny filters called nephrons. Diabetes-related high blood sugar levels can induce degeneration of blood vessels and nephrons within the kidneys, resulting in reduced performance. Furthermore, people with diabetes frequently have high blood pressure, which can contribute to kidney damage. This article will guide you on how to take care of kidneys in diabetes.

How does Type 2 Diabetes damage kidneys?

Kidneys function in maintaining homeostasis of the body by small units called nephrons. Nephron contains clusters of microscopic blood vessels called glomeruli that are responsible for filtering wastes from the bloodstream. Glomeruli excrete the unwanted substances out of the body and retain the useful substances like glucose and protein that are sent back into the bloodstream for reuse.

Kidney damage is onset after the patient is hit by type 1 as well as type 2 diabetes. Over a time of 5 years, uncontrolled blood sugar damages this fine network of blood vessels, putting stress on the kidneys and incurring high blood pressure. This, in turn, damages these fine filtering units, causing the micro blood vessels to get weak, stiff and narrow until the kidneys can’t filter enough wastes for the proper functioning of the body.

Excessive blood sugar also damages the nerves by affecting the blood vessels that supply nutrition to the nerves, causing a disorder called diabetic neuropathy. This condition affects one’s urination as the patient can no longer feel that their bladder is full and need to pass urine. This strains the kidneys because of unwanted urine accumulation. All this can lead to end-stage renal failure or, in short, kidney failure. Also read about sugar level in urine.

How is Kidney Damage/Disorder Diagnosed?

Possible Symptoms

Kidney damage can be identified by performing blood tests like protein albumin and serum creatinine. Some symptoms of progressive kidney damage are as follows :

• Dark urine because of bleeding from the glomeruli blood vessels
• Breathlessness
• Nocturia, frequent urination at night, causing sleep problems
• Fluid retention causes swollen ankles, legs and arms
• Excess levels of potassium in the blood, disrupting various metabolic functions
• Cardiovascular diseases
• Anaemia
• Damage of the light-sensitive cells behind the eye, causing diabetic retinopathy
• Erectile dysfunction
• Foot sores
• Bone diseases because of the impaired balance of calcium and phosphorus levels in the blood
• Fatigue as a result of the low supply of oxygen

Risk Factors

Diabetes is itself a risk factor for kidney damage, but some other conditions and habits make one are more prone to it than others.

• Hyperglycemia, excessive sugar levels in the blood
• High blood pressure or hypertension
• Smoking
• Drinking
• High blood cholesterol levels
• Obesity
• Hereditary kidney and diabetic disorder
• Diet rich in salt puts extra strain on the kidney glomeruli network for maintaining salt balance
• Lack of physical work
• Unable to control diet as required in controlling high blood sugar
• Cardiovascular diseases

Kidneys are responsible for filtering out toxic materials from the body and retain the filtered glucose back into the blood flow. All these factors either indicate strained kidneys (like hereditary) or lifestyle and habits that put excess strain on the kidneys (like smoking and alcohol), increase toxins in the body, and damage the fine network of blood vessels in the kidneys (like high BP and diabetes).

Can you reverse kidney damage from type 2 diabetes?

No. Kidney damage because of diabetes is irreversible, but we can always control chronic kidney disease (CKD) progression and kidney failure.

Managing diabetes by reducing high blood sugar levels is the foremost to prevent further damage to the kidneys. One can even enrol in a self-help group to connect to similar suffering people to relieve mental stress and depression. Always maintain a routine and medications prescribed by dieticians and doctors. Also know about sugar in urine test.

How to Maintain Healthy Kidneys?

One must undertake lifestyle changes to maintain the health of kidneys and control diabetes. Some changes are as follows:

• Drink lots of water
• Quit smoking as nicotine has a negative effect on diabetes and thereby kidneys
• Avoid alcohol
• Consuming fewer proteins and minimal salt
• Eating a diet rich in fibres, fruits and vegetables and legumes
• Sleep adequately
• Partake in weight loss habits to maintain a proper body mass index ratio
• Exercise like walking, swimming, jogging, biking helps in reducing blood glucose; an average of 50 minutes of weekly exercise is ideal
• Be careful before taking any over the counter medicines as certain medicines like aspirin may enhance kidney damage
• Be vigilant and always inform doctors about diabetic nephropathy conditions so that they can prescribe drugs and tests that don’t harm the kidneys

How to Treat Kidney Disorders/Damage?

If kidney damage advances so much as to cause end-stage renal failure, it means that one’s kidneys can no longer function in removing wastes from the body, causing the life-threatening accumulation of toxins within the body, in short, complete kidney failure. This situation is incurable, and one is left with a few options as follows:

1. Dialysis

Dialysis is the process of the removal of toxic chemicals and excess fluids from the blood by an artificial kidney machine. Patients need to visit the doctor at least 3 times a week for dialysis, each session requiring about 3 -5 hours. Dialysis is of two types, hemodialysis and peritoneal dialysis.

2. Kidney Transplantation

Kidney transplant is often the last resort for renal failure patients, and it is performed in healthy patients who can undergo transplant surgery. The organ is either obtained from a deceased donor or living donor who may or may not be biologically related. In either case, the various histopathological matching is performed to prevent transplant rejection. These patients can live longer and have a better life than those under dialysis.

Bottomline

Diabetes mediated kidney damage is one of the major causes of kidney failure. It is caused by continual damage of the renal network because of constant high blood sugar. Though the damage caused is irreversible, one can delay the process of kidney damage by opting for healthy habits. They can do so by controlling diabetes and blood pressure levels, thereby lessening the strain on the already injured kidneys, and by undergoing lifestyle changes like a nutrient-rich diet, daily exercise and proper medication and keeping a positive attitude. Also know about reversing type 2 diabetes.