Living with diabetes blog

Kidney disease: No early symptoms

By Nancy Klobassa Davidson, R.N. and Peggy Moreland, R.N., C.D.E. March 11, 2011

This blog is in response to a reader question about the symptoms of kidney disease that we received about our blog, "With diabetes, kidney care is crucial."

In some people with diabetes, over time, high blood glucose levels can damage the millions of tiny blood vessels that filter waste from the blood and dispose of it in the urine. Unfortunately, early kidney disease has no symptoms. Generally, not until the damage is extensive do symptoms emerge.

Symptoms of advanced kidney disease include:

  • Swelling of ankles, feet and hands
  • Shortness of breath
  • High blood pressure
  • Confusion or difficulty
  • Poor appetite
  • Nausea and vomiting
  • Dry, itchy skin
  • Fatigue

To identify kidney problems early, an important part of your yearly diabetes management checkup is getting what's called a urine microalbumin test. This test measures the amount of a protein, albumin, in your urine.

When kidneys are functioning normally, they filter out only waste in your blood, excreted in your urine. Protein and other helpful substances remain in your bloodstream. When your kidneys become damaged, waste products remain in your blood, and albumin leaks into your urine.

When your kidneys are in early distress, only small amounts of albumin escape into the bloodstream. You may lose 30 to 300 milligrams (mg) of albumin a day through the urine. This condition is called microalbuminuria. In advanced stages of kidney disease, you might lose more than 300 mg of albumin a day.

The most reliable test to screen for microscopic protein in the urine is to collect the urine in a container for 24 hours. Another available test, the random microalbuminuria test, requires only a one-time sample of urine.

If your health care provider is aware of early kidney disease through such testing, early treatment measures can help prevent or slow down the progression of diabetes-related kidney disease. Treatment measures include:

  • Keeping blood glucose levels in a healthy target range, as determined by your doctor
  • Maintaining a healthy blood pressure level, as determined by your doctor
  • Starting an ACE inhibitor blood pressure medication, which has protective benefits to the kidneys
  • Eating a low-protein diet

Your comments are appreciated.

Have a great week,

March 11, 2011