Diabetic Kidney Disease
What is Diabetic Kidney Disease (DKD)?
Diabetic Kidney Disease, also known as Diabetic Nephropathy, is a common and chronic kidney-related complication of both Type 1 and Type 2 Diabetes.
It generally occurs because an individual’s diabetes is not well controlled.
Many people with Diabetic Kidney Disease often do not even know they have it, as symptoms are often “silent” at worst or subtle at best.
About 1 in 4 people with either Type 1 Diabetes or Type 2 Diabetes will go on to develop Diabetic Kidney Disease, which hinders the kidney’s ability to remove waste and fluid from the body.
This is because high blood glucose, or high blood sugar, can damage the delicate vessels in the kidneys, in turn impeding functionality.
High blood pressure is also a cause of poorly controlled diabetes in itself, and this can also also increase the risk of diabetic nephropathy.
Being a current or former smoker, having uncontrolled high cholesterol and a family history of diabetes and/or kidney disease are other factors.
It is important to know that this condition can often be significantly prevented or delayed by maintaining a healthy lifestyle, and keeping diabetes and blood pressure in check.
All people with diabetes should visit their GP or kidney specialist for a yearly urine test that detects protein in the urine and to also check via a blood test for abnormal creatinine levels.
Unchecked, Diabetic Kidney Disease can cause fluid retention, even higher blood pressure, a rise in potassium (hyperkalemia), an increased risk of heart attack and stroke, foot sores, anemia, diarrhoea, erectile dysfunction and pregnancy complications.
Irreversible damage requires either a kidney transplant or dialysis.
The good news is that most of the complications of Diabetic Kidney Disease can be well managed with medication and lifestyle interventions.
What are the symptoms of Diabetic Kidney Disease?
Symptoms and signs of Diabetic Kidney disease include:
- Blood glucose that is too high
- Pathology that shows protein in urine
- Weakness and fatigue
- Changes in urination
- Loss of appetite
- Swelling of ankles, feet and legs
- Chest pain and pressure as fluid builds around the lining of the heart
- Shortness of breath
- An annoying and persistent itch
- Difficulties with sleep
- Mood and concentration issues, confusion
- A need for more frequent urination
Cultural differences can come in to play here too with African Americans, American Indians, Latinos and Hispanics at higher risk of this condition than Caucasians.
The only way to know if you have Diabetic Kidney Disease is for your doctor to perform blood and urine tests that will check your urine for albumin and blood tests that will see how well your kidneys are functioning and filtering.
What is the treatment for Diabetic Kidney Disease?
Lifestyle strategies to keep Diabetic Kidney Disease in check and prevent further damage include:
- Smoking cessation
- Maintaining a health weight
- Getting 7-8 hours sleep daily
- Exercising most days of the week (brisk walking is ideal)
- Limiting your salt
- Taking prescribed medicine which can include medicines for blood glucose and blood pressure control.
- The goal for the patient with diabetic nephropathy is to keep blood pressure at least under 140/90 or even better at 135/85 or less. This is particularly true in younger patients.
- Stress reduction is also important as stress is an independent risk factor so mindfulness, deep breathing, moderately vigorous exercise (under medical guidance) or even just brisk walking can help.
- Advanced CKD may require transplant or dialysis.
- The good news is that more than two thirds of people with people with Diabetic Kidney Disease do not go on to develop kidney failure, especially with regular medical check-ups and good compliance with medication and lifestyle interventions. However Diabetic Kidney Disease does still cause about 40% of all Chronic Kidney Disease worldwide, so needs to be carefully monitored.
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