Diabetes is one major risk factor for developing chronic kidney disease because long-term high blood glucose level can make the kidneys overwork to filter more blood. If this condition lasts for years,blood vessels in the kidneys will be damaged.
Inside the kidneys there are millions of tiny blood vessels (renal capillaries) which have the functions of removing wasteful products from the blood. High concentration of blood sugar in the blood can make the kidneys to filter more blood and this extra burdens will damage the renal filtration system resulting in leakage of proteins, red blood cells and retention of water, excessive electrolytes and other metabolic wastes in the body.
Not every diabetes patients will develop kidney disease, there are at present several risk factors that can speed up the progression of diabetic kidney disease.
1. Renal hemodynamic abnormalities. Hemodynamic changes play vital role in developing diabetic nephropathy or it can even be the very first inducement of renal damages. Besides, diabetes patients often have high blood pressure which has dramatic impact on affecting the progression of diabetic kidney disease.
2. Advanced glycation end products. Long term high blood glucose can cause the formation of glycation end products which can cause extracellular matrix and cell proliferation.
3. Genetic factors. It has been found that diabetic kidney disease has the feature of familial aggregation and that is why some diabetes patients will not develop kidney disease even after years of high blood sugar. Those that have family history of primary hypertension have higher risk of developing chronic kidney disease than others.
Proteinuria is the main symptom of diabetic kidney disease. The more proteins are leaked into urine, the more severe the illness condition is and the faster the decline rate of GFR and kidney functions. Most patients will develop end stage renal disease within 5-20 years after they begun to have persistent proteinuria.
Therefore treating proteinuria especially in the early stage (microalbuminuria) is very important for lowering the risk of developing kidney disease for diabetes patients. Strict control of high blood glucose and high blood pressure, weather with medicines, diets or exercises can greatly reduce microalbuminuria or even reverse it so as to much slow down illness progression.
Since diabetes patients have high incidence to develop chronic kidney disease, it is very necessary for them to have regular blood test so as to have early diagnosis and early treatment.
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