Diabetes and Kidney

Diabetes is a major cause of kidney failure worldwide and in Pakistan. Thirty to forty percent of patients of type 1 and ten to thirty percent of the patients of type 2 diabetes, develop kidney involvement. At the beginning of the kidney involvement there is very mild protein in the urine, difficult to detect by the routine methods. This is called as stage of micro-albuminuria. With the passage of time proteins in the urine increase in amount and become detectable with routine methods. At this stage other functions of the kidney also start to decline. Salt and fluid start to accumulate in the body and patients may develope edema (swelling), high blood pressure, and shortness of breath when this water accumulates in the lungs, producing a condition called as Pulmonary Edema. The waste products such as urea and creatinine start to accumulate in the body and kidney failure ensues. It takes more than 20-25 years of diabetes to develop kidney failure, but this period can be variable depending upon the type of diabetes, control of blood sugar and associated risk factors like blood pressure, urinary tract infection and smoking. Most of the patients suffering from kidney involvement also have other complications of the diabetes, like retinal damage and neuronal damage