What is diabetic kidney disease?

Diabetic kidney disease is a chronic medical condition affecting the kidneys resulting from the long-term effects of diabetes. Diabetes is considered the leading cause of kidney disease globally, with statistics indicating that about one-third of adults with diabetes suffer from some form of kidney disease [2]. The vital function of the kidneys is to filter waste and excess water from the blood to form urine, in addition to controlling blood pressure and producing hormones essential for the body. When this system is damaged due to elevated glucose levels, the kidneys begin to lose their ability to perform their functions, leading to the accumulation of waste in the bloodstream [2].

How does diabetes affect kidney function?

Kidney damage in diabetic patients usually occurs slowly and gradually over years. The primary cause of this damage is the effect of high blood sugar levels on the small blood vessels inside the kidneys, specifically the tiny filters known as "glomeruli" [3]. When these vessels are damaged, they lose their filtration efficiency, allowing important proteins, such as albumin, to pass from the blood into the urine [3]. In addition to the effect of sugar, high blood pressure, which often accompanies diabetes, contributes to increased mechanical pressure on these vessels, which accelerates the rate of kidney damage and makes them more susceptible to kidney failure if not intervened upon appropriately [2].

Early diagnosis and the importance of periodic examinations

In most cases, no clear symptoms of diabetic kidney disease appear in its early stages, making periodic examinations the only way to detect the damage [2]. It is advised that patients with type 2 diabetes, or those who have had type 1 for more than 5 years, undergo regular annual kidney examinations [2]. Basic tests include an albumin-to-urine test, which is a major protein in the blood that should not be found in large quantities in normal urine, and a blood creatinine test, which helps calculate the estimated glomerular filtration rate (eGFR) to assess the kidney's efficiency in filtering toxins [1].

Preventive and therapeutic steps to maintain kidney health

Prevention strategies center on strict control of the main risk factors. This requires working with the medical team to reach specific goals for blood sugar levels, as lowering glycosylated hemoglobin (A1C) to target levels (often less than 7% for most adults) contributes directly to protecting the kidneys [2]. Controlling blood pressure is also of critical importance, with doctors usually aiming to keep blood pressure below 140/90 mmHg [2].

Doctors may prescribe certain medications such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), which are medications proven effective in slowing the progression of kidney damage in those with diabetes and high blood pressure, in addition to using sodium-glucose cotransporter 2 (SGLT2) inhibitors in specific cases [3]. For more details on care and prevention methods, please see the article Diabetic Kidney Disease: Early Screening and Prevention of Kidney Failure (Arabic). You should always discuss all treatment options with your specialist doctor to ensure they are appropriate for your specific health condition.

Medical references

• Creatinine Test
• Diabetic Kidney Disease
• Glomerular Disease