Diabetes is a disease that involves insulin and glucose metabolism; it occurs in both children and adults. Complications of diabetes can affect many areas of the body, especially the heart, eyes and kidneys. Testing for increased protein in the urine, or albuminuria, can detect early kidney damage and encourage steps to maintain better diabetic control.
Diabetes Mellitus
Diabetes is caused by a failure of the body to regulate glucose properly, resulting in high blood sugar and subsequent damage to blood vessels and major organs. The vast majority of adults develop type 2 diabetes, involving both insufficient insulin production and a decreased response by the body's cells to the insulin produced. Some people can control their type 2 diabetes through weight loss, physical activity and a healthy diet, but others will require oral medication or insulin shots. Long-term diabetic complications can include heart disease, blindness and kidney damage.
Diabetic Nephropathy
Your blood is constantly cleaned and filtered by the kidneys as it passes through millions of tiny blood vessels in structures called glomeruli. These vessels allow waste materials to pass through their walls for excretion in the urine, while holding back blood cells and useful proteins like albumin. Prolonged exposure to high sugar levels with diabetes, progressively damages the blood vessels, allowing albumin to leak into the urine and eventually destroying the glomeruli. This common diabetic complication, called diabetic nephropathy, is more likely to occur in people who have poorly controlled blood sugar, high blood pressure, smoke and have a family history of kidney problems, according to MedlinePlus.
Testing for Nephropathy
The earliest sign of diabetic nephropathy is protein in the urine, with laboratory screening recommended at least annually for all diabetics between 12 and 70 years of age. A random urine sample, collected at any time of the day, is usually tested initially. If albuminuria is detected, additional tests such as a 24-hour urine collection for protein level, blood urea nitrogen and creatinine levels are usually performed to check for other evidence of kidney damage.
Albuminuria and Microalbuminuria
Albuminuria is a common marker for kidney damage, and microalbuminuria is the earliest stage in the process when you can detect only minimal amounts of the protein. Diabetes, high blood pressure, congestive heart failure and other unrelated kidney diseases can all cause albuminuria, which is also occasionally seen in healthy people, according to the National Kidney Foundation. The finding of albuminuria in a diabetic is associated with more rapid progression of kidney damage, an increased chance of future kidney failure and higher likelihood of other diabetic complications developing.
Response and Treatment
Albuminuria in its early stages is potentially reversible and improving control of your diabetes can slow or limit the progression of kidney damage. Important steps include maintaining good control of blood sugar levels, keeping blood pressure below 130 over 80 mm Hg, not smoking, remaining physically active and eating a healthy diet. Medications for blood pressure or glucose control might be required, and a low protein diet is sometimes recommended as kidney damage progresses. Kidney failure is not always preventable and dialysis or kidney transplant may eventually become necessary.
