The human kidney is a vital component of the body’s efficient waste disposal system. A healthy kidney cleans the blood by filtering out waste products, which are then routed to the urine. Over time, high blood sugar levels can damage the cells and tiny blood vessels that perform this cleansing function. The result is a damaged kidney that routes waste back into the body and releases excess amounts of protein into the urine. Symptoms of kidney failure are fatigue, decreased appetite, nausea, and vomiting.

About 30 to 40 percent of people with Type 1 diabetes and 20 to 30 percent of those with Type 2 diabetes will develop moderate to advanced kidney disease. However, since the damage occurs slowly over time, taking action early allows for the prevention of the worst consequences.

Prevention

In the DCCT, the intensive control group (the group that successfully controlled their blood sugars) experienced up to 54 percent less kidney disease compared to the moderate control group (which had less control). Therefore, the best way to prevent kidney disease is to maintain blood sugar levels as normal as possible. Remember that this reduction in kidney damage is just due to improved blood sugar control in those with early kidney disease. Other protective measures, which are more effective in the later stages of kidney disease, are discussed in Chapter 30.

Following these additional suggestions will do a lot toward preventing serious problems:

Have your urine checked regularly for microalbumin (a simple urine test). This detects kidney disease at its earliest stage, when intervention is most effective. This test should be performed at least once a year. If any abnormal readings occur, discuss with your doctor how and how often you should be monitored for kidney function.
Control your blood pressure through diet, relaxation techniques, and blood pressure medications (especially an ACE inhibitor).
If you have a family history of high blood pressure or kidney disease, discuss with your physician the use of an ACE inhibitor to prevent kidney disease.
Be alert for signs of bladder or urinary tract infections and treat them promptly. Symptoms include burning when urinating, frequent urination, cloudy urine, and a strong smell to the urine.
Decrease animal protein in the diet if you have any kidney disease or a family history of it. For helpful cookbooks, visit Nephron.

Nephron has additional information on Preventing Kidney Disease

Also see Kidney Disease Stages and Reversal