Diabetes affects your body’s ability to regulate blood sugar (glucose).
In patients with DKD, kidney disease leads to kidney scarring, which leaves them less able to filter waste out of the blood. Over time, this could ultimately lead to kidney failure.
More than likely, you will not notice any symptoms from early stages of diabetic kidney disease. Instead, the best way to check for it is through routine urine and blood tests.
Tests of your urine will examine its levels of albumin. Albumin is a protein that leaks into your urine from damaged kidneys. The higher the level of albumin, the more likely you have some kidney damage.
However, in later stages of kidney disease, the symptoms might be more serious. You should tell your doctor immediately if you notice fatigue, changes in your appetite, muscle cramps, swollen feet or ankles, or paleness in your skin.
Depending on the extent of the kidney damage, you may have a number of treatment options.
There are medications — like ACE inhibitors and Angiotensin Receptor Blockers (ARBs) — that can help protect your kidneys and heart.
However, if the damage is too severe, you may be a candidate for dialysis. If you’ve been diagnosed with DKD, discuss these options with your doctor.
Symptoms & Complications
Electrolytes are elements and compounds that play important roles in your body’s functions. They’re present in your bodily fluids, and you also ingest them in food, drinks, and supplements.
The balance of electrolytes is maintained by several organs in your body — including your kidneys. Too much, or too little, of any of these electrolytes can lead to dangerous problems. It’s very important to treat them as soon as they arise.
Hemodialysis is a treatment option for electrolyte problems induced by kidney failure. Your doctor may decide this is the best course of action if the imbalance is serious enough.
Below are examples of electrolyte imbalances related to kidney disease.
CALCIUM
Calcium plays an important part in the health of your bones, teeth, and blood vessels.
Kidney disease and kidney failure can lead to an imbalance of calcium levels in your body. This can cause bone deformities and heart problems. See also: Mineral & Bone Disorders.
CHLORIDE
Chloride works with other electrolytes to regulate the amount of fluid in your body. It also maintains a proper balance of acidity.
Excess chloride is a possible complication of kidney failure. It can lead to changes in blood pressure and a narrowing of blood vessels around the kidneys.
MAGNESIUM
Magnesium is one of the most important minerals. It regulates some of your body’s most critical functions, including heart rhythm, muscle contraction, and nerve function.
Excessive magnesium in the blood (called hypermagnesemia) is rare while the kidneys are functioning. But in end-stage kidney disease, hypermagnesemia can lead to very serious problems — including respiratory depression and abnormal electrical activity in the heart.
POTASSIUM
Potassium helps conduct nerve impulses, and regulates the flow of nutrients into and out of your body’s cells.
Too much potassium can be triggered by kidney failure, and it could be fatal if left untreated. It can cause weakness, nausea, paralysis, and abnormal heart rhythms.
SODIUM
Sodium helps maintain fluid balance in your body. It’s essential for many physiological functions.
Kidney failure can lead to hyponatremia, which happens when your body retains too much water, relative to the amount of sodium. It’s a serious condition that can cause brain swelling, muscle spasms, and seizures.
PHOSPHATE
Phosphate closely interacts with calcium in your blood and is necessary for a variety of processes in your body.
Kidney disease can lead to excess phosphate, which can cause itchiness, muscle cramps, joint pain, and rashes.
Swelling in the legs, feet, and ankles—called edema—is not a specific disease. But, it can be a sign of kidney problems.
Healthy kidneys filter excess fluid from your blood, so you can pass it as part of your urine. When kidneys stop functioning well, this extra fluid stays in your body, and gravity tends to pool it around your lower legs (although sometimes it can also gather around your eyes).
Because kidney-related edema worsens as kidney function declines, patients on dialysis tend to experience edema frequently between procedures. While this kind of edema may look disturbing, it’s usually not dangerous.
However, if you’re experiencing pain alongside your swelling, or shortness of breath, it could be a sign that your edema is being caused by something else—like heart issues, cirrhosis, or deep-vein thrombosis.
Each of these is a serious medical emergency. If you have any of these symptoms, you should seek care immediately.
Kidney stones are salt and mineral deposits that form inside your kidneys. Although they initially take shape in the kidneys, they can affect any part of the urinary tract—from the kidneys, to the ureters, to the bladder.
There’s no single cause of a kidney stone, and they vary by which minerals compose them. But certain conditions—like diabetes, obestiy, and high blood pressure — may increase your risk for them. Prolonged dehydration, and a diet with excess sodium and protein, can also contribute.
Kidney stones are very difficult to detect until they’re large enough to cause symptoms. At that point they may shift into your ureter, and you’ll experience symptoms like pain in the lower back, abdomen, or groin; painful urination; pink, red, brown, cloudy, or foul-smelling urine; nausea and vomiting; and urinating unusually small amount.
Sometimes, the best course of action is to wait until you pass kidney stones through your urine. This can be very painful, but usually causes no lasting damage. Hydration and pain medication can help. Sometimes, however, they may require surgery.
If you suspect you have a kidney stone, consult your physician to determine the right treatment plan.
How Kidneys Affect Bone Health
In healthy people, kidneys contribute to bone health by keeping phosphorus and calcium in balance in the bloodstream. They do this in two ways:
- By activating vitamin D you consumed in food, and turning it into calcitriol, a hormone that promotes bone growth and healthy calcium regulation.
- By filtering excess phosphorus from your blood.
What Happens When Kidneys Stop Working?
Kidneys impaired by disease, however, are less able to perform either of these processes. If damaged enough, they stop activating calcitriol, and they are less able to filter phosphorus.
This begins a phosphorus build-up, and the excess phosphorus saps calcium from bones, which weakens them.
Further, significant kidney damage causes your body’s parathyroid glands (pea-sized glands in your neck) to secrete parathyroid hormone. This hormone also draws calcium out of your bones. The whole process restores a healthy balance of calcium and phosphorus in your blood -- but it also makes your bones weaker.
What Can Kidney-Related Mineral Disorders Do to My Bones?
Some people call this kidney-related mineral disorder “The Silent Crippler,” as it can lead to bone deformities that can seriously compromise your mobility. It can also damage or impair blood vessels, which can cause heart problems.
In patients with chronic kidney disease, blood tests, a bone biopsy, or an X-ray are usually used to confirm mineral and bone disorders. If you have concerns about your bone health, you should ask your physician about these tests.
Treatment for mineral and bone disorders can involve modifying your diet to avoid phosphorus; taking supplements and medications to restore healthy hormonal function; and undergoing dialysis to control phosphorus levels in the blood
What is Proteinuria?
An abnormal amount of protein in your urine is called proteinuria. It’s not an illness, but it could be a sign of one.
Temporary, or transient, proteinuria is usually not a serious concern. It can be brought about by stress, dehydration, or other factors. Pregnant women also tend to show higher levels of protein in their urine.
However, long-lasting chronic proteinuria is a sign of potentially dangerous dysfunction.
How is it Diagnosed and Treated?
Treatment for proteinuria depends on its underlying cause. That could be an excess of protein production in the body. More often, it’s an early sign of kidney disease.
Proteinuria could indicate that your kidney’s filters are not functioning as they should. They’re allowing excess protein to leak from your blood into your urine. This could mean that the kidney’s tissues have been damaged by disease.
You’re unlikely to notice proteinuria at home. (Although, sometimes protein-rich urine can appear frothy.) Instead, it’s usually detected with urine tests during a routine physical.
Diabetes and hypertension (high blood pressure) are both risk factors for proteinuria. Patients with these conditions should pay close attention to urinalysis results.
To prevent progressive damage to the kidneys, treating the root cause of proteinuria is very important. Options include dialysis, and medicines like Angiotensin Receptor Blockers (ARBs).
If you have proteinuria, consult your physician to see what treatment path is right for you.