Diabetes is a very dreadful disease of all as it is incurable and lasts till the end. Apart from this it keeps on causing lot of other troubles and malfunctioning of various organs, especially liver and kidney due to which diabetes has to be always kept under control.  Around 100,000 people get affected with kidney failure every year in United States. It is a condition in which the kidney fails to clean the wastage of body and the waste gets accumulated in the body. Failure of kidney is the last and final stage of CKD or chronic kidney disease.

Diabetes is considered as one of the major reasons for kidney complication and account for around 44% of total kidney problems. The figures are really very startling. Although people with diabetes and having kidney problem do not necessarily die, many have to face kidney complications. Around 24 million people in America are currently suffering from diabetes out of which 180000 people had to face kidney failure due to diabetes. The kidney disease related to diabetes does not erupt suddenly. Rather it takes years to turn into a real complication. 

Diabetic patients face the risk of urinary tract infections, renal atherosclerosis, papillary necrosis and glomerular lesions.  The diabetic nephropathy found can be mostly diffuse or nodular. In the early stages, it can cause increase in the filtration rate of the glomerular along with enlarged kidney. Even then the main characteristics of diabetic nephropathy are proteinuria which develops slowly and subtly but is very harmful. It begins as irregular microalbuminuria before fully developing into regular proteinuria. This sometimes outgrow into nephritic syndrome. .

Epidemiology facts

• In type 1 diabetes, kidney damage has been traced as the main reason for causing renal failure, especially in the working group
• In people affected with type 2 diabetes, kidney disease is elevating as there is rise in such affliction especially in the younger generation
• Around 40% people with type 1 diabetes get affected with microalbuminuria 30 years from the prevalence of diabetes
• Approximately 20 to 25% of patients with type 2 diabetes get affected with microalbuminuria 10 years from the prevalence of the disease

Detecting and checking kidney complications

Clinical features do not surface till the kidney disease or related complication has become advanced and chronic. There are many instances of neglecting diabetes control which further aggravates the problem. The earlier symptoms of kidney problems usually found in diabetic patients are lethargy, thirst etc. which many times can be left unattended. But these problems should be essentially assessed so as to avoid further complications.

Some of the assessments that should be done in such cases are:

• Arranging recall annually for people suffering from both 1 and 2 type of diabetes
• Annually measuring urinary albumin: creatinine ratio or albumin concentration
• First morning urine sample is mostly used for such tests
• If the proteinuria or an urinary tract infection is not detected and the ratio of albumin : creatinine is abnormal, the test should be conducted second time in the gap of 3 to 4 months
• Annually measuring of serum creatinine and estimated glomerular filtration rate (eGFR)