Diabetes is the most common cause of kidney failure in the United States. Nearly 44 percent of the 100,000 people diagnosed with kidney disease (nephropathy) have diabetes. Among the 24 million people in the U.S. who have diabetes, around 180,000 have been diagnosed with kidney failure.

How does diabetes affect kidneys?

In those with diabetes, small blood vessels in the body are injured, including blood vessels in the kidneys. When those blood vessels are injured, kidneys lose ability or have a decreased ability to properly clean blood. As this happens, the body begins to retain more water and salt than it should, you gain weight and have swelling in the ankles, excess protein appears in the urine, and waste material builds up in the blood. Diabetes may also cause nerve damage in the body that can make it difficult to empty your bladder. This may injure the kidneys by causing back up.

How common is kidney failure?

Research conducted by Leiden University Medical Center in the Netherlands and reported at the American Society of Nephrology Kidney Week 2014 suggests that diabetic nephropathy is even more common than originally thought.

Researchers collected kidney tissue samples from 150 deceased individuals who had type 1 or type 2 diabetes during their lifetime. Nearly 50 percent of the deceased tested positive for diabetic nephropathy at their time of death. Celine Klessens, author of the study, says, “Our findings show a histologically proven diabetic nephropathy in…more patients than would have been estimated clinically.”

Some of these patients had exhibited diabetic nephropathy in their life, though only three out of the 150 test subjects had undergone a kidney biopsy during their lifetime.

What can you do?

Unfortunately, there is no cure for diabetic kidney disease. However, improved and increased kidney monitoring could be helpful in early diabetic nephropathy diagnosis. Keeping your blood sugar and blood pressure under control and properly managing your diabetes can help your kidneys stay healthy and functioning. It's also recommended you avoid high-protein diets if you are at risk for kidney failure.

It is also helpful to watch for possible early warning signs of diabetic nephropathy so you can get diagnosed as soon as possible. Get annual blood, urine, and blood pressure tests to check for increased excretion of albumin in the urine and high blood pressure. You can also look out for weight gain, swelling in the ankles, and an increased need to use the bathroom at night.

The best way to lower your risk of severe kidney disease is to maintain control of your diabetes.

For more on diabetes and nephropathy:

Treating Diabetic Kidney Disease
Protecting Your Kidneys
What’s Damaging Your Kidneys?