What is it?

Diabetic need disease (diabetic nephropathy) is a problem that happens in case of people suffering from diabetes. It is seen in this case of some of the diabetic patients. When this happens the glomeruli (the filters of the kidneys) become damaged and as a result of that the kidneys may leak abnormal amounts of protein from the blood into the urine.

The protein that goes out from damaged kidneys is known as albumin. In normal healthy kidneys a tiny amount of albumin is present in the urine. When the albumin increases in the urine that can be the typical first sign of kidney damage because of diabetes. This diabetic kidney disease is generally divided into two categories-microalbuminuria and proteinuria. It is also known as incipient nephropathy.

Microalbuminuria-in this problem, the albumin found in the urine is between 30 to 300 mg per day.

Proteinuria-in this problem the albumin that goes into the urine is than 300 mg per day. Sometimes it is also called as overt nephropathy.

How does the problem develop?

Because of an increasing blood sugar (glucose) level can result in a rise in some chemicals in the kidney and these chemicals can cause the glomeruli leak more. If that happens, more albumin will leak in to the urine. The higher blood glucose level may also cause some proteins in the glomeruli to bind together and such cross-linked proteins can trigger a localized scattering process. This process is known as glomerulosclerosis. However, it will take several years for the development of this problem and it is seen only in case of some people with diabetes.

If the condition worsens, scarred tissue will start to replace healthy kidney tissue gradually. So the kidneys will become less efficient and they will not be able to filter the blood as they did before. The kidneys will start to fail gradually and will result in end stage kidney failure.

Microalbuminuria can be the first sign that diabetic kidney disease has developed. After several months or years microalbuminuria may go away or it can remain at the same level or progress to proteinuria. Once proteinuria stage is reached, it becomes irreversible. Gradually the kidney function will decline and end stage kidney failure will happen in the future.

Is the problem very common?

Diabetic kidney disease is generally more common in case of people with type 1 diabetes. However, it may also occur in people with type 2 diabetes. The number of people with diabetes kidney disease is more in case of type 2 diabetes because the type 2 diabetes is more common than type 1 diabetes. Diabetic kidney disease is the most common cause of kidney failure. People who suffer from diabetic kidney disease one in five such people need dialysis.

People with type 1 diabetes

Microalbuminuria or proteinuria is not generally present at the time of first diabetes diagnosis. Five years after the diagnosis of diabetes, one in seven people may develop microalbuminuria. After 30 years, four in 10 people may develop microalbuminuria.

People with type 2 diabetes

In case of type 2 diabetes, when the diabetes is first diagnosed, one in eight people develop microalbuminuria and one in 50 may have proteinuria. This happens because many people who suffer from type 2 diabetes do not get their diabetes diagnosed for quite some time even after the disease start for the first time.

If you did not have any kidney problem when the diabetes was diagnosed, in five years microalbuminuria may develop about 1 in 7 people and proteinuria in 1 in 20 people.

References

1. How To Improve Diabetic Kidney Disease
2. Diabetic Kidney Disease
3. Diabetic Kidney Problems