What are the effects of diabetes on kidneys?

Kidneys are remarkable organs. Inside them there are millions of tiny vessels that act as filters. Their job is to
remove waste products from the blood. 10-21% of all people with diabetes have nephropathy. Approximately 43% of new cases of ESRD[end stage renal disease] are attributed to diabetes.
Why diabetes can cause kidney damage.

When our bodies digest the protein we eat, the process creates waste products. In the kidneys millions of tiny blood vessels[capillaries] with even tiny holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. The 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 sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak. useful protein is lost through this leak and leaves the body through urine. Having small amounts of protein in the urine is called microalbyminuria. When kidney disease is diagnosed early[during microalbuminuria] several treatments may keep kidney disease from getting worse. Having large amounts of protein in urine is called macroalbuminuria. When kidney disease is found later[during macroalbuminuria] end stage renal disease, or ESRD occurs.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 sugar control,and blood pressure. The better a person keeps diabetes and blood pressure under control, the lower are the chances of getting kidney disease. Your kidney function should be checked at least once a year or earlier if advised by your doctor.
Important treatments for kidney disease are tight control of blood glucose and blood pressure. Blood pressure has a dramatic effect on the rate at which the disease progresses. Even a mild rise in blood pressure can quickly make kidney disease worsen.


Four ways to lower the blood pressure are
a]Losing weight
b]Eating less salt
c]Avoiding alcohol and tobacco
d]Regular exercise.
If kidney disease sets in, eat low protein diet. If this method fails, certain medication may help to lower blood pressure. ACE inhibitors are necessary for most people with diabetes, high blood pressure and kidney disease. Once kidney fails, dialysis is must. The person than is left to choose whether to continue with dialysis or to go for a kidney transplant.
Raghu Natrajan