One of the more common long-term complications of diabetes is diabetic renal disease. Also known as diabetic nephropathy, this condition is a result of direct vascular abnormalities that accompany diabetes.

Around 20 to 30 per cent of people with diabetes develop diabetic nephropathy, although not all of these will progress to kidney failure. A person with diabetes is susceptible to nephropathy whether they use insulin or not. The risk is related to the length of time the person has diabetes.

There is no cure for diabetic nephropathy, and the treatment continues for life. Another name for the condition is diabetic glomerulosclerosis. People with diabetes are also at risk of other kidney problems, including narrowing of the arteries to the kidneys, called renal artery stenosis or renovascular disease.

Diabetes mellitus is a condition characterized by high blood glucose (sugar) levels. Over time, the high levels of sugar in the blood damage the millions of tiny filtering units (Glomeruli) within each kidney. This eventually leads to kidney failure. Diabetes mellitus is the main cause of end-stage renal disease (ESRD), the most advanced stage of kidney disease. 

Why does diabetes increase the risk for kidney disease?

High blood sugar can overwork the kidneys, which over time will 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. 

What should I do if I have diabetes?

Many of the risk factors for kidney disease 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, see The Pocket Dietitian™
  • 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.)

For people with diabetes, kidney problems are usually picked up during a check-up by their doctor. Occasionally, a person can have type 2 diabetes without knowing it. This means their unchecked high blood sugar levels may be slowly damaging their kidneys. At first, the only sign is high protein levels in the urine, but this has no symptoms. It may be years before the kidneys are damaged severely enough to cause symptoms. Some of the symptoms may include:

  • Fluid retention (edema of the legs or face)
  • Fatigue
  • Headache
  • Nausea
  • Vomiting