Diabetes causes kidney disease due to damage of the filtration system in the kidneys. High levels of blood sugar make the kidneys filter too much blood and over time cause the kidney function to weaken and leak useful protein necessary for a healthy life. When kidneys are healthy, red blood cells and useful protein are too big to filter and remain in the blood. When kidneys begin to fail, waste products build up in the blood resulting in kidney failure and if not addressed, is fatal. The leading cause of kidney failure in America is diabetes and a kidney transplant may be the only option once failure occurs.
Individuals with diabetes may damage their kidneys when glucose levels are not controlled. Eventually, the kidneys become so damaged that they are unable to filter wastes and extra fluid from the blood. Diabetic kidney disease is the term that best describes kidney disease caused by diabetes.
Individuals with diabetes should routinely be checked for kidney disease.
Diabetic nephropathy is a common complication found in type 1 and type
2 diabetes. Uncontrolled high blood sugar, uncontrolled high blood pressure,
high blood cholesterol, obesity and a family history of diabetes and kidney disease increase the risk of diabetic nephropathy.
Symptoms of diabetic nephropathy include:
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Changing or fluctuating blood pressure even with medication
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Protein in the urine
-
An increased need to urinate
-
Swelling of eyes, hands, ankles and feet
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Changes, usually a reduced need for, insulin or diabetes medicine
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Confusion, difficulty concentrating, fatigue, loss of appetite, persistent itching
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Shortness of breath
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Nausea and vomiting
Blood tests and urine tests are used to determine kidney health. A glomerular filtration rate or GFR of 60 or more indicates normal function, while a rate of less than 60 indicates potential kidney disease. Kidney failure exists when the GFR is 15 or less indicating a need for dialysis or kidney transplant. Creatinine levels may also be monitored as creatinine goes up as kidney disease gets worse. Urine tests for albumin, a protein in the blood, is used to determine if kidney is damaged and letting albumin pass into the urine. A healthy kidney prevents albumin from being excreted.
The less albumin in the urine the better.
Complications of diabetic nephropathy may develop over time and may include:
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Fluid retention, leading to swelling in extremities, high blood pressure or pulmonary edema (fluid in the lungs)
-
Hyperkalemia, or a rise in potassium; potassium is critical to the function of nerve and muscle cells
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Cardiovascular disease which could lead to stroke
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Diabetic retinopathy
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Anemia or reduced red blood cells that carry oxygen
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Erectile dysfunction, diarrhea, and other problems related to damaged nerves and blood vessels
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Bone disorders as the kidneys are unable to balance calcium and phosphorous in the blood
-
Pregnancy complications
-
Irreversible kidney damage (end-stage kidney disease) leading to dialysis or kidney transplant in order to survive
The sooner kidney disease is managed the less chance for heart disease,
kidney failure and the better chance at improving overall health. Managing kidney disease includes:
-
Controlling blood pressure
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Maintaining a safe blood glucose level if you have diabetes
-
Working with the diabetes care team to monitor kidney health
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Taking medications as prescribed
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Avoiding over the counter medications unless approved by the physician as some nonsteroidal anti-inflammatory drugs (NSAIDs) may damage the kidneys
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Filling prescriptions at only one pharmacy so the pharmacist can keep track of prescriptions and check for harmful interactions
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Keeping a list of all medications and supplements in your wallet
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Working with a dietitian on an optimal meal plan
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Taking part in physical activity
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Controlling weight or losing weight under the diabetes care team guidance
-
Getting sufficient rest and sleep
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Stopping smoking
-
Developing stress management and healthy coping strategies
Treatment involves managing and controlling diabetes and high blood pressure.
This includes adhering to diet recommendations, making appropriate lifestyle choices or changes, appropriate exercise and prescription medications.
Appropriate management may prevent or delay kidney dysfunction and other complications.
Future efforts in diabetes management, including regenerative medicine,
may benefit people with diabetic nephropathy. If diabetes can be cured by pancreas islet cell transplant or stem cell therapy, kidney function may improve.
Agencies & Associations
2849 American Association of Kidney Patients
14440 Bruce B. Downs Boulevard
Tampa, FL 33613
813-636-8100
800-749-2257
Fax: 813-636-8122
info@aakp.org
www.aakp.org
Serves the needs and interests of kidney patients, for kidney patients,
the purpose of this Association is to help patients and their families cope with the emotional, physical and social impact of kidney disease.
Diana Clynes, Executive Director
2850 American Kidney Fund
11921 Rockville Pike
Rockville, MD 20852
800-638-8299
helpline@kidneyfund.org
www.kidneyfund.org
A non-profit national health organization providing direct financial assistance to thousands of Americans who suffer from kidney disease.
LaVarne A. Burton, President & CEO
Tara Bunch, Executive Vice President
& COO
2851 American Society of Nephrology
1401 H Street NW
Washington, DC 20005
202-640-4660
Fax: 202-637-9793
email@asn-online.org
www.asn-online.org
Mission is to lead the fight against kidney disase and advance research.
Susan E. Quaggin, MD, FASN, President
Deidra C. Crews, MD, MS, FASN, Secretary
2852 Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244
410-786-3000
877-267-2323
TTY: 866-226-1819
www.cms.gov
U.S. federal agency which administers Medicare, Medicaid, and the State Children’s Health Insurance Program.
Chiquita Brooks-LaSure, Administrator
Karen Jackson, COO
2853 National Institute of Biomedical Imaging and Bioengineering
9000 Rockville Pike
Bethesda, MD 20892
301-496-3500
e-mail: info@nibib.nih.gov
www.nibib.nih.gov
The mission of the National Institute of Biomedical Imaging and Bioengineering
(NIBIB) is to improve health by leading the development and accelerating the application of biomedical technologies.
Bruce J. Tromberg, PhD, Director
Jill Heemskerk, PhD, Deputy Director
2854 National Institute of Diabetes & Digestive & Kidney Diseases
9000 Rockville Pike
Bethesda, MD 20892
800-860-8747
healthinfo@niddk.nih.gov
www.niddk.nih.gov
Research areas include diabetes, digestive diseases, endocrine and metabolic diseases, hematologic diseases, kidney disease, liver disease, urologic diseases, as well as matters relating to nutrition and obesity.
Griffin P. Rodgers, MD, MACP, Director
Gregory Germino, MD, Deputy Director
2855 National Institute of Environmental Health Sciences
P.O. Box 12233
Durham, NC 27709
919-541-3201
Fax: 919-541-5136
NIEHSDirector@nih.gov
www.niehs.nih.gov
The mission of the NIEHS is to discover how the environment affects people in order to promote healthier lives.
Rick Woychik, PhD, Director
Gwen W. Collman, PhD, Acting Deputy Director
2856 National Institute of General Medical Sciences
45 Center Drive
Bethesda, MD 20892
301-496-7301
e-mail: info@nigms.nih.gov
www.nigms.nih.gov
The National Institute of General Medical Sciences (NIGMS) supports basic research that increases understanding of biological processes and lays the foundation for advances in disease diagnosis, treatment and prevention.
Jon R. Lorsch, PhD, Director
Dorit Zuk, PhD, Deputy Director
2857 U.S. Food and Drug Administration
10903 New Hampshire Avenue
Silver Spring, MD 20993
888-463-6332
www.fda.gov
FDA is responsible for protecting the public health by assuring the safety,
efficacy and security of human and veterinary drugs, biological products,
medical devices, the nation’s food supply, cosmetics, and products that emit radiation.
Janet Woodcock, MD, Acting Commissioner
Foundations
2858 National Kidney Foundation
30 E 33rd Street
New York, NY 10016
800-622-9010
855-653-2273
Fax: 212-689-9261
info@kidney.org
www.kidney.org
A health organization dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected and increasing the availability of all organs for transplantation.
Kevin Longino, CEO
Joseph Vassalotti, Chief Medical Officer
Research Centers
2859 Kidney Disease Institute
Wadsworth Center for Laboratories and Research
Empire State Plaza
Albany, NY 12237
518-474-7354
Fax: 518-737-71
dohweb@health.state.ny.us
www.nyhealth.gov
An information and referral organization for polycystic kidney disease autoimmune kidney disease and transplantation.
Andrew M Cuomo, Governor
Nirav R Shah, Commissioner
2860 Lovelace Medical Foundation
2425 Ridgecrest Drive SE
Albuquerque, NM 87108
505-348-9400
Fax: 505-348-8567
info@lrri.org
www.lrri.org
Jackie Lovelace Johnson, Director
Frank Bond, Director
2861 Lovelace Respiratory Research Institute
615 S Preston Street
Louisville, KY 40202
502-852-7350
Fax: 502-852-7643
kdpnet.kdp.louisville.edu
Educates residents and patients regarding kidney diseases and offers a dialysis clinic for people afflicted with kidney disease.
George R Ottensmeyer, President
2862 National Institute of Diabetes & Digestive & Kidney Disease
US Department of Health and Human Services
9000 Rockville Pike
Bethesda, MD 20892
301-496-3583
800-422-6237
Fax: 301-496-7422
The Institute conducts, fosters, and supports basic and clinical research into the causes, prevention, diagnosis, and treatment of the various metabolic and digestive diseases. It covers the broad areas of diabetes, blood, endocrine,
and metabolic diseases; digestive diseases and nutrition; and kidney and urologic diseases.
Elizabeth Singer, Executive Director
2863 Nevada Kidney Disease & Hypertension Centers
210 S Desplaines Street
Chicago, IL 60661
312-654-2720
Fax: 312-654-0118
charlotte.chapple@ainmd.com
www.ainmd.com/
A medical group practicing nephrology in the Chicago metropolitan area and it suburbs. Includes 21 nephrologists with expertise in many areas in the field of nephrology including hypertension chronic and acute renal failure hemodialysis and peritoneal dialysis glomerulonephritis acid base disturbances fluid and electrolytes management. Provides personal high quality care to patients with kidney diseases.
Eduardo Kantor MD, Founder
2864 PKD Foundation Polycystic Kidney Disease Foundation
Polycystic Kidney Disease Foundation
9221 Ward Parkway
Kansas City, MO 64114
816-931-2600
800-PKD-CURE
Fax: 816-931-8655
pkdcure@pkdcure.org
www.pkdcure.org
The foundation exists to win the war with PKD. Their mission is to promote research into the treatment and cure of polycystic kidney disease by raising financial support for peer approved biomedical research projects and fostering public awareness among medical professionals patients and the general public.
Frank Condella, Jr, Chair
Michelle Davis, Interim CEO/Chief Development Officer
2865 University of Kansas Kidney and Urology Research Center
3901 Rainbow Boulevard
Kansas City, KS 66160
913-588-5000
Fax: 913-588-3995
TTY: 913-588-7963
www.kumc.edu
Jared J Brosius, Chief
Joseph Messana, Professor/ Service Chief
2866 University of Michigan Nephrology Division
University of Michigan Health System
1500 E Medical Center Drive
Ann Arbor, MI 48109
734-936-5645
Fax: 734-763-4151
www.med.umich.edu/intmed/nephrology
Focuses on kidney research.
Eric Mullen, Division Administrator
Susan Geisser, Financial Consultant
2867 University of Rochester: Nephrology Research Program
601 Elmwood Avenue
Rochester, NY 14642
585-275-3660
Fax: 716-442-9201
www.urmc.rochester.edu
Focuses on kidney disorders.
David A Bushinsky, MD, Division Chief
2868 Warren Grant Magnuson Clinical Center
National Institute of Health
10 Center Drive MSC 1078
Bethesda, MD 20892
301-496-3311
800-411-1222
Fax: 301-496-2390
TTY: 866-411-1010
mmichael@cc.nih.gov
www.dnrc.nih.gov/reports/programs/ncc.as
Established in 1953 as the research hospital of the National Institutes of Health. Designed so that patient care facilities are close to research laboratories so new findings of basic and clinical scientists can be quickly applied to the treatment of patients. Upon referral by physicians, patients are admitted to NIH clinical studies.
John Slatopolsky, Director
2869 Washington University Chromalloy American Kidney Center
One Barnes-Jewish Hospital Plaza
Saint Louis, MO 63110
314-362-7209
Fax: 314-747-3743
renal.wustl.edu
Offers a dialysis unit for people afflicted with kidney disease.
Dr Eduardo Lanning RN/JD, President Board of Directors
Sean Tully, Vice President Board of Directors
Support Groups & Hotlines 2870 Kidneeds
Greater Cedar Rapids Community Foundation
200 First Street Southwest
Cedar Rapids, IA 52404
319-366-2862
Fax: 319-386-0431
kidneedsmpgn@yahoo.com
www.medicine.uiowa.edu/kidneeds/
Primary mission of kidneeds is to fund research on membranoproliferative giomerulonephritis type 2 (MPON type 2, aka, dense deposit disease). Phone support and annual newsletter availiable. No computerized version availiable.
No mailing list availble.
Lynne
2871 National Health Information Center
Office of Disease Prevention & Health Promotion
1101 Wootton Pkwy
Rockville, MD 20852
Fax: 240-453-8281
odphpinfo@hhs.gov
www.health.gov/nhic
Supports public health education by maintaining a calendar of National Health Observances; helps connect consumers and health professionals to organizations that can best answer questions and provide up-to-date contact information from reliable sources; updates on a yearly basis toll-free numbers for health information, Federal health clearinghouses and info centers.
Don Wright, MD, MPH, Director
Digital Resources
2872 It’s Just Part of My Life
National Kidney Foundation
30 E 33rd Street
New York, NY 10016
212-889-2210
800-622-9010
Fax: 212-689-9261
www.kidney.org
A 15-minute program for adolescent dialysis patients and their families.
Web Sites
2873 American Association of Kidney Patients
www.aakp.org
Serves the needs and interests of kidney patients, for kidney patients,
the purpose of this Association is to help patients and their families cope with the emotional, physical and social impact of kidney disease.
2874 American Kidney Fund
www.akfinc.org/
A nonprofit, national health organization providing direct financial assistance to thousands of Americans who suffer from kidney disease.
2875 Elder Options of Texas
www.elderoptionsoftexas.com
An online directory for seniors in the state of Texas. Find information on care facilities, home care services, community activities, legal assistance for the elderly, insurance agents, medical devices, meal plan services,
and more.
2876 Healing Well
www.healingwell.com
An online health resource guide to medical news, chat, information and articles, newsgroups and message boards, books, disease-related web sites,
medical directories, and more for patients, friends, and family coping with disabling diseases, disorders, or chronic illnesses.
2877 Health Finder
www.healthfinder.gov
Searchable, carefully developed web site offering information on over 1000
topics. Developed by the US Department of Health and Human Services, the site can be used in both English and Spanish.
2878 Healthlink USA
www.healthlinkusa.com
Links to websites which may include treatment, cures, diagnosis, prevention,
support groups, email lists, messageboards, personal stories, risk factors,
statistics, research and more.
2879 MedicineNet
www.medicinenet.com
An online resource for consumers providing easy-to-read, authoritative medical and health information.
2880 Medscape
www.medscape.com
Medscape offers specialists, primary care physicians, and other health professionals the Web’s most robust and integrated medical information and educational tools.
2881 Polycystic Kidney Research Foundation
www.pkdcure.org
Provide information on research into the cause, treatment, and cure of polycystic kidney disease by raising financial support for peer approved biomedical research projects and fostering public awareness among medical professionals, patients and the general public.
2882 WebMD
www.webmd.com
Provides credible information, supportive communities, and in-depth reference material about health subjects. A source for original and timely health information as well as material from well known content providers.