We know a lot about how diabetes affects your body’s blood glucose (sugar) levels, and it’s widely understood that diabetics often have high blood pressure and high cholesterol, both of which can lead to an increased risk of heart disease. But not everyone knows that diabetes can contribute to chronic kidney disease – and it does so fairly often. If you are concerned about diabetes’ affect on your kidneys, consult your doctor. Diabetic Kidney Disease More than 35% of diabetics over the age of 20 have chronic kidney disease. And diabetes can greatly increase the risk of advancing to the final stage of kidney disease: kidney failure. In fact, diabetes accounts for 44% of new cases of kidney failure. According to recent government surveys, of nearly 24 million people in the U.S. with diabetes, 180,000 are living with kidney failure as a result of the disease. So what’s the diabetes-kidney connection? Your kidneys help to “cleanse,” or regulate, your blood. They work to prevent excess amounts of fluid and waste from piling up in the body, and they also maintain healthy levels of electrolytes and hormones in your blood. But since diabetes so greatly affects your body’s blood glucose levels, it can affect the kidneys’ ability to keep your blood clean and healthy. If all that harmful waste builds up because your kidneys can’t clean your blood, your body will begin to break down, which can lead to myriad symptoms: weakness, shortness of breath, lethargy and confusion. Additionally, if your kidneys fail to remove the appropriate amount of electrolytes in your blood, your risk of heart failure increases. Even with successful control of diabetes, kidneys are susceptible to disease, due to their role in controlling the health of blood and the removal of excess waste. Know the Symptoms Diabetes affects the kidneys by damaging the body’s small blood vessels; this can occur for years without showing symptoms. The blood vessels damaged in the kidneys prevent the organs from properly doing their job – cleaning the body of excess waste and regulating electrolytes and hormones in blood cells. Without such regulation, the body is subject to several harmful effects, including water and sodium retention (which can lead to swollen feet and ankles) and nerve damage, which can result in difficulty urinating, painful urination and even urinary tract infections. Essentially, diseased kidneys cause less clearance of insulin – which is hazardous for those with diabetes. As symptoms begin to emerge, you may note other signs of diabetes affecting your kidneys, like the presence of protein in urine, high blood pressure, cramps and swelling in legs, frequent urination, abnormal blood tests, fatigue, nausea, anemia, weakness, pallor, itching, diabetic eye disease (including retinopathy, glaucoma and cloudiness in the lens) and decreased need for insulin or anti-diabetic pills. Many of these symptoms occur later as the disease progresses, including high blood urea nitrogen levels, nausea, and anemia. And avoiding treatment can lead, ultimately, to kidney failure, which occurs when the kidneys can no longer support the body. In that case, dialysis or kidney transplantation will be necessary. For diabetics with kidney disease, several treatments are available: kidney transplantation, hemodialysis (the use of a machine to continue the function of kidneys) and peritoneal dialysis (another way to filter, which can be done at home). Talk to your physician if you are experiencing any of these symptoms. Working with your doctor to find an appropriate balance of diet, exercise and blood regulation can help to treat diabetic kidney disease. Continue to monitor blood glucose levels, control blood pressure, and follow your prescribed healthy diet. Lowering salt and protein intake in your diet can reduce the load on the kidneys.