Young diseases

There’s a lot you can do to prevent kidney problems. A recent study shows that controlling your blood glucose can prevent or delay the onset of kidney disease. Keeping your blood pressure under control is also important. Diabetic kidney disease happens slowly and silently, so you might not feel that anything is wrong until severe problems have developed.

Therefore, it is important to get your blood and urine checked for kidney problems each year. Your doctor can learn how well your kidneys are working by testing every year for micro-albumin (a protein) in the urine. Micro-albumin in the urine is an early sign of diabetic kidney disease. Your doctor can also do a yearly blood test to measure your kidney function. Go to the doctor if you develop a bladder or kidney infection; symptoms include cloudy or bloody urine, pain or burning when you urinate, an urgent need to urinate often, back pain, chills, or fever.


What are the early signs of kidney disease in Diabetes?
The finding of excess amounts of protein in the urine is an early sign of diabetic kidney disease.

This usually occurs after 10 to 15 years of diabetes. If the protein loss should become heavy, the amount of protein in the blood decreases. This low blood protein level results in fluid retention causing swelling of the legs.

High blood pressure usually develops or worsens as the disease progresses. People with diabetes should have their blood, urine and blood pressure checked regularly by their doctor. This will lead to better control of the disease and early treatment of high blood pressure, if present.

What are the late signs of kidney disease in Diabetes?
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As the kidney's function declines (this is shown by the results of progressive blood tests), non-specific symptoms may develop such as nausea, vomiting, loss of appetite, weakness, tiredness, itchiness, muscle cramps and anaemia.

The need for insulin may decrease. If any of these symptoms occur you should consult your doctor.

What happens if the kidneys fail completely?
If the kidneys become so damaged that only about 10% of overall kidney function remains, it is called End-Stage Kidney Failure.

The average time between the onset of diabetic kidney damage and End-Stage Kidney Failure is about 5 to 7 years, but it can vary from person to person.

For diabetics in a reasonable state of health, End-Stage Kidney Failure can be treated by dialysis or transplantation.

Can a person with Diabetes have a kidney transplant?
Yes, a kidney transplant can come from a deceased person (cadaver transplant) or from a close blood relative (living related transplant). However, it is important for the recipient not to have other organ damage due to diabetes, for example, to the heart, brains and eyes. If these are already present, a transplant may not be suitable.

Important points about Diabetes and the kidney
* Severe kidney failure is much more common in Type 1 (juvenile-onset) than Type 2 (adult-onset) Diabetes;
* Diabetes may affect small blood vessels in the kidney and cause permanent kidney damage (Diabetic Nephropathy) and kidney failure;
* Early diabetic kidney damage (Diabetic Nephropathy) can be detected by a urine test. The most practical way to follow the condition of the kidneys is with blood tests;
* Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with Type 1 Diabetes)
* Maintaining normal blood pressure is the most effective method for slowing the rate at which kidney function is lost;
* End-Stage Kidney Failure can be treated by kidney transplantation, haemodialysis or peritoneal dialysis.