Q: I have diabetes, and recently my doctor told me that I have kidney disease as well. What does that mean?
Diabetes is a major risk factor for chronic kidney disease (CKD) and a third of people with diabetes go on to develop CKD. This happens because diabetes can damage the small blood vessels in the kidneys, making it harder for the kidneys to work properly. When the kidneys start to fail, they can no longer clean your blood the way they should which leads to water, toxin and acid building up in your body.
Treatment to prevent diabetic kidney disease should begin early- before kidney damage develops. Blood pressure control and strict control of blood sugar levels is very essential in preventing kidney damage.
In the early stages of chronic kidney disease (stages 1-3), you may not notice anything at all, or sometimes your blood pressure may be high, and your ankles may be swollen. Symptoms of later-stage kidney disease (stages 4-5) include fatigue, anemia, loss of appetite, morning sickness, itching, a metal taste in your mouth, trouble sleeping, feeling extremely tired, or trouble breathing properly. You may find that your sugar is lower and need less insulin, since your kidneys are not functioning well enough to get rid of insulin you are using.
Once you are diagnosed with CKD, your doctor will work with you to keep your kidneys healthy for as long as possible by controlling your diabetes and blood pressure, and treating any urinary tract infections. You will also need to follow a special diet, called a renal diabetic diet, which is low in sodium as well as potassium, phosphorous, and protein -- nutrients that can build up in your blood when you have CKD.
If your kidneys stop working and are no longer able to keep you healthy, this is called end stage renal failure. At this point, you will need a kidney transplant or dialysis in order to stay alive.
Kristen Tamura, MD
85 Maui Lani Parkway
Wailuku, HI 96793