Diabetes is the No. 1 cause of chronic kidney disease as well as end-stage renal disease, or ESRD, or kidney failure. According to the National Kidney and Urologic Diseases Information Clearinghouse, almost 44 percent of all cases of kidney failure are caused by diabetes. In addition, people with type 2 diabetes have an elevated risk for developing kidney stones, according to research performed by Mary Ann Cameron and colleagues.
Chronic Kidney Disease
There are five stages of chronic kidney disease, and the fifth and worst stage is the one in which kidney failure occurs. Yet early or moderate kidney disease has no symptoms, which is why it is important for people with diabetes to ask their doctors about tests for kidney function. For example, blood can be tested for declining kidney function with a kidney test of the glomerular filtration rate, or GFR, while urine can be checked for any protein in the urine, or proteinuria. If protein is present, this indicates a person has kidney disease. Awareness of kidney disease in the early stages is important because individuals with diabetes and kidney disease can become more vigilant about testing their blood and watching their diet to keep their glucose levels down. In addition, many diabetics are hypertensive and it's important to keep blood pressure to as close to normal as possible to reduce the risk of kidney failure.
Kidney Failure
If the kidneys fail, then either dialysis or a kidney transplant are the two options to survive. Dialysis involves the use of special equipment to filter the blood, since the kidneys can no longer handle this function. Some people whose kidneys have almost failed and who still have some kidney function have preemptive transplantation in which they have a kidney transplant without ever having dialysis. Others may have dialysis before transplantation but then have a simultaneous pancreas-kidney transplant, which essentially cures the diabetes, since the new pancreas will be healthy and nondiabetic.
Kidney Stones
People with type 2 diabetes have a greater risk than others of forming kidney stones, and it is believed that this is because their urine is significantly more acidic, according to Cameron and colleagues. People with diabetes are especially at risk for forming kidney stones made of uric acid, says Cameron. Obesity may be a factor, since the subjects in the diabetes group had a significantly higher body mass index than the nondiabetic subjects in the study.
