Question: How will I know if my kidneys have been damaged by diabetes?

To know if your kidneys have been damaged by diabetes, check for the following signs and symptoms:

1. Frequent urination at night (more than 3x/night) and/ or bubbling urine. The earliest sign of kidney disease in a person with diabetes is the presence of protein (specifically, albumin) in the urine, which in significant amounts, can cause bubbling when
   spilled in the urine by the kidneys.
2. Increase in blood pressure, weight gain, and leg edema. With kidney damage, your body will retain more salt and water than it should.
3. Tiredness, itchiness, nausea, vomiting, and loss of appetite. Your kidneys are your body’s “waste machines” and when they are damaged, they cannot clean your blood properly and waste products accumulate in your blood causing these symptoms.
4. Paleness and weakness. Kidneys produce a substance called erythropoietin and this is needed by the body to produce red blood cells. Thus, with kidney disease, patients develop anemia.
5. Need to lower doses of insulin or oral antidiabetic pills. This is because damaged kidneys result in less breakdown of insulin.
6. Frequent urinary tract infections (UTI). Diabetes may also cause damage to the nerves of your bladder. As a result you may have difficulty in emptying bladder which can predispose you to frequent UTIs.

Consult your doctor if you have any of these signs and symptoms. Moreover, you should have your urine and blood checked for the following at least once a year or as recommended by your doctor.

1. Urine micral test. This is a sensitive urine test that can detect small amounts of protein (known as microalbuminuria) long before there is evidence of kidney disease in the usual blood tests.
2. Creatinine. You can get an estimate of your kidney function by computing for your kidneys glomerular filtration rate (GFR) based on this simple blood test. The higher the creatinine, the lower the GFR, and the worse your kidney function is.

With these basic tests, your doctor can tell you how your kidneys are working or if you need to see a kidney doctor (nephrologist). Without proper treatment, the time between the start of diabetic kidney damage to end stage kidney failure is about 5 to 7 years. End stage kidney disease means that your kidney function is already less than 15 percent of normal and at this level, the kidneys are no longer able to support your body in a reasonably healthy state. If this occurs, you will need to undergo dialysis or transplant. However, early detection and treatment can prevent this from happening.

Ask your doctor regarding your chances of having diabetic kidney disease.  Having diabetes does not always mean o you will have kidney disease and your kidneys will fail. Your doctor can plan your 3 treatment with you.

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