Diabetes is the leading cause of kidney failure in nearly half of the new cases in the United States. More than 100,000 people are diagnosed with kidney failure each year. Discover more about kidney disease, dialysis, and diabetes.

The Basics about Kidney Disease

It can take many years for kidney disease to develop. In the beginning, small amounts of a blood protein called albumin leak into the urine. Typically, the kidneys continue to filter normally during this first stage of kidney disease referred to as micro-albuminuria. Over time, more albumin gets into the urine and the ability for the kidneys to filter decreases. This stage is called proteinuria or macro-albuminuria. The body starts to retain wastes and kidney damage occurs as a result of this lack of filtration. Kidney failure is most likely to occur after 15 to 25 years of diabetes. People with diabetes for over 25 years with no signs of kidney problems have a lower risk of developing kidney disease.

Kidney Disease and Diabetes

There are about 24 million people in the United States with diabetes and nearly 180,000 of them have kidney failure. Most people do not experience kidney failure, which is the final stage of chronic kidney disease (CKD). It occurs when the kidneys fail to get rid of body waste. When people have diabetes, it can cause injury to small blood vessels in the body. If these blood vessels are in the kidneys, they are unable to properly clean the blood. As a result, your blood retains excessive amounts of salt and water. This causes symptoms such as swollen ankles and weight gain, as well as protein in your urine and blood in your waste. Diabetes can also cause nerve damage. This makes it harder to empty your bladder. A full bladder backs up and can lead to injury of your kidneys. Urine with high sugar levels that stays in the bladder can lead to infections due to the quick growth of bacteria. This condition may also lead to CKD.

What about High Blood Pressure?

People with diabetes are also more likely to have high blood pressure. The leading cause of kidney failure is diabetes and the second most likely cause of kidney problems is high blood pressure. Use a blood pressure monitor daily and report irregularities to your health care team. Exercise every day and eat a low sodium diet to reduce the risks associated with kidney disease and high blood pressure.

Medical Monitoring Matters

People with diabetes should get a kidney screening at least once a year. Talk to your doctor about scheduling one. If kidney disease is detected, patients are advised to control their blood sugar levels, blood pressure and visit with a kidney specialist. A consultation with a dietician specializing in kidney disease should also be arranged. Ask your doctor to help you be proactive about kidney disease by routinely measuring your A1C levels. Your eGFR, BUN and creatinine levels should be monitored. Your blood pressure should be checked during every medical examination and at home. Work with your health care team to minimize the possibility of kidney disease and failure. Taking an ARB or ACE inhibitor can help protect your kidneys. Take your diabetes medications as prescribed to help keep your blood sugar levels regulated. Exercise daily by doing aerobic activities such as walking, biking, and swimming to help lower your blood pressure. Find ways to minimize stress, including relaxation techniques such as deep breathing exercises or biofeedback. Limit or eliminate your intake of sugary and salty foods. Ask your doctor about reducing foods that are high in potassium or protein.

What is Dialysis?

Once chronic kidney disease leads to Stage 5, called kidney failure, dialysis is recommended. Signs of kidney failure include fatigue, nausea, dry skin, weight loss, difficulty sleeping, muscle cramps, puffy eyes, anemia, abnormal bruising or bleeding, and trouble breathing. Dialysis is a way to artificially clean the blood of waste products. Dialysis removes the extra fluid and accumulated wastes from your blood. During dialysis, your blood is pumped through tubes to a dialysis machine. The treatments take about 3 to 5 hours and are done usually 3 times weekly. They might be done at an out patient dialysis center, in a hospital setting, or in your own home. If they are done at home, requirements include adequate space, electric power, and water drainage to operate the unit as well as a care partner. There are 3 basic types of home dialysis including conventional, short daily home dialysis, and nocturnal dialysis while you sleep. Discuss your options with your health care team to choose the right one for your situation.


Maintaining blood sugar and blood pressure control can help people with diabetes avoid kidney disease and failure. For those who experience kidney disease, healthy lifestyle habits and ongoing treatment can make a difference. Talk to your health care team today about kidney disease and how you can minimize its potential impact on your life.