Spilling protein is a common term that refers to the presence of protein, called albumin, in a person's urine. Kidney damage caused by diabetes is called diabetic nephropathy. Checking the urine for the presence of albumin is one way of screening for diabetic nephropathy. The American Diabetes Association recommends that people who have diabetes receive regular screenings for diabetic nephropathy because treatment is most effective when problems are detected in the early stages.
Causes
The kidneys are responsible for filtering the blood and removing wastes from the body. Uncontrolled blood sugar levels can damage the delicate networks of the kidneys. The risk of kidney damage is increased if you also have uncontrolled high blood pressure. When the kidneys' complex network of filters and blood vessels become damaged, the kidneys do not filter as well and allow larger particles, such as protein, to pass through into the urine. Left unchecked, the condition can progress to severe kidney disease and kidney failure.
Prevalence
The American Diabetes Association says 20 to 30 percent of people with type 1 and type 2 diabetes develop some degree of kidney problems. Not all of these people will go on to develop severe kidney disease, but diabetes nephropathy remains the most frequent cause of kidney failure requiring dialysis. Diabetes nephropathy tends to occur more frequently in certain ethnic groups, particularly African-Americans, Hispanics and Native Americans. Smoking, poorly controlled blood sugar levels, poorly controlled high blood pressure and being diagnosed with type 1 diabetes before age 20 are also risk factors for the development of diabetes-related kidney disease.
Screening
In its earliest stages, diabetic nephropathy has no symptoms. The earliest sign of kidney damage is the presence of albumin in the urine. If you have type 2 diabetes, the American Diabetes Association recommends that annual kidney screening begin soon after you're diagnosed. If you have type 1 diabetes, it is recommend that screening begin five years after diagnosis. Your doctor might order additional blood tests to measure the extent of kidney problems, including BUN (blood urea nitrogen) and creatinine levels.
Treatment
Early treatment can help keep diabetes nephropathy from getting worse. The Cleveland Clinic emphasizes the importance of blood pressure and blood sugar control for protecting the kidneys from further damage. The American Diabetes Association recommends specific medications called ARBs, or angiotensin receptor blockers, and ACEIs, or angiotensin-converting enzyme inhibitors, for the treatment of nephropathy in people who have diabetes and high blood pressure.
Learning More
You can learn more about diabetic nephropathy by talking to your doctor or health care team. Your doctor, diabetes educator and/or dietitian can help you learn about risk factors, prevention, detection and treatment for diabetic nephropathy.
