Diabetic Kidney Disease

What is Diabetes?

Diabetes mellitus (Diabetes) is a disease in which the body doesn't produce enough, or responds poorly, to insulin, which leads to abnormally high blood sugar (glucose) levels. Insulin is a hormone produced by the pancreas that regulates the amount of sugar in the blood. An elevated blood sugar level can cause problems and/or damage to different parts of the body.

There are 2 types of Diabetes:

• Type 1: Type 1 diabetes usually appears at a young age usually as a result of the body destroying the beta cells that make insulin. It is also called “insulin-dependent diabetes mellitus”. In this type of diabetes, the pancreas does not make any or not enough insulin and patients have to take insulin injections to make up for that.

• Type 2: Type 2 diabetes, also called “adult onset diabetes mellitus” or “non insulin-dependent diabetes mellitus”, is more common than type 1. It usually occurs in middle age patients. Here, the pancreas produces insulin, but the body does not respond to it properly. The high blood sugar level can often be controlled by following a diet and/or medication but some patients might also need to take insulin.


Diabetes is the leading cause of chronic kidney disease in developed countries and rapidly is becoming so in developing countries as well, as a consequence of the global increase in type 2 diabetes and obesity. 


In the United States, some type of kidney damage can be diagnosed in up to 43% of diabetic patients, more than twice the amount of people than in 1980.

How does diabetes affects the kidneys?

Diabetes affects many different parts of the kidneys but the damage is particularly important in the small blood vessels, known as glomeruli, of the kidneys. When these very important components are damaged, the kidneys cannot function normally and the blood is not cleaned properly. This leads to many complications including the retention of salt and water which can lead to swelling and weight gain, and to the accumulation of toxic waste substances that should be normally eliminated from the blood.

Diabetes can also injure the nerve system which can lead to difficulties emptying the bladder. The accumulation of urine in the bladder can put a lot of pressure on the kidneys which may lead to more damage.

If urine remains in the bladder for a long time, patients can develop urinary infections due to the growth of bacteria in a urine rich in sugar.



  1. Radica Z. Alicic, Michele T. Rooney, Katherine R. Tuttle. CJASN Dec 2017, 12 (12) 2032-2045; DOI: 10.2215/CJN.11491116.
  2. KDOQI. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Am J Kidney Dis 2007; 49:S12.
  3. Diabetic Nephropathy: Diagnosis, Prevention, and Treatment. Jorge L. Gross, Mirela J. de Azevedo, Sandra P. Silveiro, Luís Henrique Canani, Maria Luiza Caramori, Themis Zelmanovitz. Diabetes Care Jan 2005, 28 (1) 164-176; DOI: 10.2337/diacare.28.1.164.


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