Kidney disease due to diabetes is known as diabetic nephropathy, and it develops in less than half of the people at risk to get it. Some important factors contribute to kidney disease (some of which you can't change and some of which you can):
I Abnormal blood fats promote thickening in the kidneys. You can reduce this contributing factor.
I Certain ethnic groups, especially African Americans, Native Americans, and Mexican Americans, tend to have nephropathy more often. You can't change this.
I Elevated blood pressure damages the kidneys of a person with diabetes. Blood pressure should be measured at each doctor's visit and compared with the appropriate chart for age, height, and weight (Chapter 7 has more about measuring blood pressure). You can control blood pressure; for assistance, check out my book High Blood Pressure For Dummies (Wiley).
In the following sections, I explain the impact of uncontrolled diabetes on the kidneys and tell you how to prevent and treat kidney damage.
Uncontrolled diabetes can affect the kidneys in many ways, depending on the stage of the disease. Luckily, with regular testing for an important indicator (microalbuminuria), anyone can lessen the impact of kidney disease before it progresses.
Figure 5-3 shows the appearance of the normal glomerulus of the kidney, the structure that filters the blood. There are 2 million of these glomeruli in a person's kidneys, so loss of even a whole kidney isn't fatal.
Blood passes through the tiny glomerular capillaries, which are in intimate contact with tubules through which filtered blood travels. As the filtered blood passes through the tubules, most of the water and the normal contents of the blood are reabsorbed into the body while a small amount of water and waste passes from the kidneys into the ureter, into the bladder, and out the urethra (refer to Figure 5-3). The loops of capillaries are supported by a thin membrane called the mesangium and are surrounded by a sac called the Bowman's capsule. Between the capillaries and the mesangium is the glomerular basement membrane, the membrane through which filtration takes place.
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