Although not all people with diabetes will experience kidney problems, having the disease does present a serious risk for developing diabetic nephropathy. That’s because diabetes creates complications that may affect your kidneys’ ability to do their job effectively. In fact, diabetes mellitus is the number one cause of chronic kidney disease in the US.
Detecting if Diabetes Affects Your Kidneys
Developing diabetes presents all sorts of logistic complications like regulating blood sugar and taking insulin shots. Although it can feel very overwhelming to manage the disease itself, getting tested for diabetic nephropathy doesn’t have to be.
The process takes a simple urine sample. We check this urine for protein and creatinine levels. To quantify the amount of protein in the urine more precisely, we have you collect your urine for 24 hours to give us a more accurate estimate.
Health care practitioners may begin to check for protein in the urine at the time of diagnosis in the case of type II diabetes and five years after the diagnosis of type I – and then yearly thereafter. Investigation may also include checking your kidney function, HbA1C levels, lipid profile, and an assessment of whether diabetes is affecting other organs as well.
Understanding Diabetic Nephropathy
So what exactly happens when diabetes affects your kidneys?
- Diabetes mellitus commonly affects three major organs: kidneys, eyes, and nerves
- The earliest sign of diabetes affecting your kidney is the finding of protein in your urine (microalbuminuria)
- Diabetic nephropathy develops in about 30% of patients with type II diabetes (20% of these patients will end up on dialysis)
- Major risk factors: poor blood sugar control, hypertension, smoking, being male, family history
How to Address Diabetic Nephropathy
If you test positive for diabetic nephropathy, you may be wondering what to do going forward. Actions taken may vary depending upon other co-occurring diseases and certain demographic factors.
That said, good blood sugar control is critical! The goal is to get hemoglobin A-1 C levels less than seven (of course, lower than this is even better). Even more important is controlling your blood pressure. The higher the BP, the greater chance you have for protein excretion in the urine. The target blood pressure depends on the amount of protein you have in your urine.
A class of drugs called ACE Inhibitors and/or ARB’s may also be used by your doctor. Talk to them about the side effects of these drugs. Multiple studies have shown these drugs to be protective and beneficial (if tolerated) in patients with diabetic nephropathy. It not only lowers the BP but also slows protein excretion into the urine.
Remember: Serial labs and medications of course don’t take the place of exercise and diet!