Kidneys are one of the most vulnerable organs for complications associated with diabetes. If preventive and protective measures are taken soon enough, the kidney complications associated with diabetes can be delayed, or even avoided. With long-term good blood sugar control, the risk of complications – particularly those affecting the kidneys – is low.
The kidneys: a filter
Diabetes is the most common cause of kidney disease. Prolonged hyperglycemia damages the renal filter, by overusing the kidney but also by impacting the surrounding blood vessels: this is known as diabetic kidney disease or diabetic nephropathy. The kidneys are very sensitive to blood sugar levels, and also to high blood pressure. In particular, poorly controlled diabetes can change the membrane of the glomeruli, kidney structures that are essential to filter the blood.
It should also be noted that as a result of the neuropathic lesions associated with diabetes, bladder emptying can also be affected in some rare and severe cases. The impact on the kidneys must not be overlooked, in particular with infections, which are more common as a result of high blood sugar.
The development of kidney disease is an insidious process; there are few, if any, symptoms before severe damage has occurred, which is why regular screening and testing are so important.
The earliest signs show up in the laboratory, with the presence of microalbuminuria detected following a urine test. Albumin is a large blood protein, not usually present in the urine. “Micro” means that it can now be detected in very small quantities. Microalbuminuria indicates that someone is at risk of developing kidney disease, and is not necessarily a serious symptom. It is an early warning, designed to protect the kidneys.
If no measures are taken to protect the kidneys, the renal filter will continue to be damaged and let more and more protein through the urine: this is the proteinuria stage. The term kidney (or renal) failure is used when the kidney is no longer able to fulfil its filtration functions, measured by the amount of creatinine and urea in the blood, among other tests.
Early detection is essential
There is a direct correlation between diabetic kidney disease and blood sugar control. The incidence of kidney disease starts to increase 7 years after the onset of diabetes; it’s at this point that doctors generally perform tests to check for kidney damage. But today, even after the appearance of microalbuminuria, it has been demonstrated that it’s possible to combat diabetic kidney disease. There are now medicines available – also used to treat high blood pressure – that protect the kidneys, halting the progression of kidney damage, in particular, when microalbuminuria, which is the first indicator, begins to develop. These treatments are therefore recommended even in the absence of high blood pressure.
The prevention and treatment of kidney complications associated with Type 1 diabetes are more and more effective. A balanced, low-salt diet, stable blood sugar levels, regular blood pressure monitoring and protective treatments have substantially improved the renal prognosis in Type 1 diabetes.