How Are Diabetes and Chronic Kidney Disease Linked?

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Chronic illnesses are prevalent across the United States. Diabetes affects over 34 million people in the U.S. while Chronic Kidney Disease (CKD) impacts more than 37 million adults. Both are significant public health concerns.

Interestingly, these two diseases are not isolated; they have an interconnected relationship, often leading to a vicious cycle of worsening health outcomes.

The Connection Between Diabetes and CKD

The link between diabetes, specifically type 2 diabetes, and CKD is well established. Diabetes is the leading cause of CKD and End-Stage Renal Disease (ESRD) worldwide.

Per MDPI, in 2017, the age-standardized prevalence of CKD in patients with diabetes was approximately 25 per 1,000 in the US. Furthermore, according to the CDC approximately 1 in 3 adults with diabetes have CKD. 

The high blood sugar levels associated with diabetes damage the nephrons, tiny filtering units in the kidneys. Over time, this leads to a condition known as diabetic nephropathy, the leading cause of kidney failure in the U.S.

Early diabetic nephropathy often presents with no symptoms. As kidney function worsens, symptoms may include swelling of the hands, feet and face, trouble sleeping or concentrating, and poor appetite. Diabetic nephropathy is usually diagnosed during regular testing that’s part of managing diabetes, which may include a urinary albumin test. 

In addition to high blood sugar and high blood pressure, other risk factors for diabetic nephropathy include smoking, high blood cholesterol, obesity, and a family history of diabetes and kidney disease.

How Diabetes Leads to Kidney Damage

In diabetes, excess glucose in the bloodstream can cause damage to various body parts, including the kidneys. Prolonged exposure to high glucose levels leads to changes in the kidney’s blood vessels, impairing their function and leading to protein leakage into the urine, a condition known as albuminuria.

High blood pressure, a common co-morbidity in people with diabetes, puts extra stress on the blood vessels in the kidneys, which accelerates the damage caused by high blood sugar levels.

Mitigating the Risk

Proper management of diabetes can significantly reduce the risk of developing CKD. Regular check-ups, good blood pressure, adhering to prescribed medication, maintaining a healthy diet, regular physical activity, and avoiding tobacco use can contribute to better outcomes with CKD.

Summary 

Diabetes is a leading cause of CKD and ESRD, with high blood sugar levels damaging the kidneys over time. This damage can lead to diabetic nephropathy, a condition often symptomless in its early stages but can lead to severe health issues if left unchecked. It is important to manage diabetes to reduce the risk of developing CKD, this includes getting regular check-ups, maintaining a healthy lifestyle, and adhering to prescribed medication.

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