Blood sugar control and kidney health -
In the kidneys, millions of tiny blood vessels capillaries with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes.
These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood. Diabetes can damage this system.
High levels of blood glucose blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine.
Having small amounts of protein in the urine is called microalbuminuria. When kidney disease is diagnosed early, during microalbuminuria, several treatments may keep kidney disease from getting worse. Having larger amounts of protein in the urine is called macroalbuminuria.
When kidney disease is caught later during macroalbuminuria, end-stage renal disease ESRD usually follows. In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail.
This failure, ESRD, is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine dialysis. Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood glucose management, and blood pressure.
The better a person keeps diabetes and blood pressure well-managed, the lower their chance of getting kidney disease. The kidneys work hard to make up for the failing capillaries, so kidney disease produces no symptoms until almost all function is gone.
Also, the symptoms of kidney disease are not specific. The first symptom of kidney disease is often fluid buildup. Other symptoms of kidney disease include loss of sleep, poor appetite, upset stomach, weakness, and difficulty concentrating. It is vital to see a doctor regularly.
The doctor can check blood pressure, urine for protein , blood for waste products , and organs for other complications of diabetes.
Because GLUT2 is involved in the tubular reabsorption of glucose, glucosuria is a feature of the nephropathy. While renal glucose reabsorption is a glucose-conserving mechanism in normal physiologic states, it is known to contribute to hyperglycemia in conditions such as T2DM.
Diabetes has become the most common single cause of endstage renal disease ESRD in the United States and Europe; this is most likely due to several evolving factors, including an increased prevalence of T2DM, longer life spans among patients with diabetes, and better formal recognition of renal insufficiency.
ESRD spending represents 6. The epidemic growth in ESRD cases has led to skyrocketing utilization of healthcare resources. Since undetected T2DM may be present for many years, a higher proportion of individuals with T2DM vs type 1 diabetes mellitus have microalbuminuria and overt nephropathy shortly after diagnosis.
As interventions for coronary artery disease continue to improve, however, more patients with T2DM may survive long enough to develop renal failure. Increasing evidence demonstrates that the onset and course of diabetic nephropathy may be significantly altered by several interventions eg, tight glucose control, use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers , all of which have their greatest impact if instituted early.
As such, annual screening for microalbuminuria is critical since it leads to early identification of nephropathy. Well-known data from the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study established that intensive glycemic control may significantly reduce the risk of developing microalbuminuria and overt nephropathy.
The observed reduction in nephropathy is important, since indices of renal impairment are strongly associated with future risk of major vascular events, ESRD, and death in patients with diabetes. The regulation of glucose production, uptake, reabsorption, and elimination is handled by several organs, most notably historically the pancreas and liver.
Under normal circumstances, glucose filtered by glomeruli is completely reabsorbed, but in conditions of hyperglycemia or reduced resorptive capacity, glucosuria may occur. In hyperglycemia, the kidneys may play an exacerbating role by reabsorbing excess glucose, ultimately contributing to chronic hyperglycemia, and subsequently to pancreatic β-cell failure, insulin resistance, and decreased glucose uptake.
Hyperglycemia in turn detrimentally affects the kidneys by damaging glomeruli, ultimately causing microalbuminuria and nephropathy.
Author affiliations: Department of Medicine, Division of Diabetes, University of Texas Health Science Center at San Antonio; and Texas Diabetes Institute, San Antonio, TX.
Funding source: This activity is supported by an educational grant from Bristol-Myers Squibb and AstraZeneca LP. Author disclosure: Dr Triplitt reports being a consultant or a member of the advisory board for Roche and Takeda Pharmaceuticals.
Authorship information: Concept and design; drafting of the manuscript; and critical revision of the manuscript for important intellectual content. Download PDF: Understanding the Kidneys' Role in Blood Glucose Regulation. All News. Press Releases. Product Approvals and Launches. Clinical Spotlight.
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You are here Home » A to Z » Diabetes - A Major Risk Factor for Kidney Disease. Diabetes - A Major Risk Factor for Kidney Disease. English Español. Table of Contents What is diabetes? Are there different types of diabetes? What does diabetes do to the kidneys?
How many people with diabetes will develop kidney disease? What are the early signs of kidney disease in patients with diabetes? What are the late signs of kidney disease in people with diabetes?
What will happen if my kidneys have been damaged? How are the kidneys kept working as long as possible? What is end stage kidney failure in patients with diabetes? How is kidney failure treated in people with diabetes? Can a person with diabetes have a kidney transplant?
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Diabetes kiidney the most common cause of kidney failure in the United Boost your immune system. This metabolic disorder changes the way the body Blopd or uses insulin. Insulin Blood sugar control and kidney health a hormone kidneg helps regulate sugar glucose in Performance-enhancing meal plans blood. When blood sugar levels get too high, the condition is called hyperglycemia. Hyperglycemia is a problem for people with diabetes, and it poses a significant health risk when you have chronic kidney disease CKD. If your diabetes is not controlled, it can lead to increased loss of kidney functioncardiovascular diseasevision loss and other complications. If you have diabetes you are likely to have had experience with hyperglycemia. Diabetic kidney disease is a type cojtrol kidney disease Zugar by diabetes. Diabetes is Nutrient timing leading cause of kidney disease. Kivney Performance-enhancing meal plans out of 3 adults with diabetes has kidney disease. The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.
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