Diabetes mellitus is a disease in which the
body either fails to produce enough insulin or is unable to use insulin properly.
Insulin is a hormone that is needed to convert sugar, starches, and other
food into energy used for daily life. If there is not enough insulin, blood
glucose (sugar) levels can become high. High levels of glucose in the bloodstream
for long periods can damage a number of body organs and systems, including
the kidneys.The June 25, 2003, issue of JAMA includes an article about kidney
complications in patients with diabetes.
The kidneys filter wastes and water from the blood, creating urine.
Urine passes from the kidneys through 2 tubes called ureters to the urinary
bladder and is then eliminated from the body.
Diabetes is the most common cause of kidney failure. Over time, high
levels of blood sugar in the body lead to permanent kidney injury. When the
kidneys lose most of their function, waste products and fluids build up in
the blood. If untreated, this ultimately leads to death.
Leakage into the urine of albumin, one of the
main proteins that circulate in the blood, is an early sign of kidney damage
due to diabetes. This is called albuminuria. Aggressive
control of blood glucose levels and blood pressure can slow the progression
to kidney failure. It is very important for anyone with diabetes to have regular
medical checkups to assess control of their diabetes and to identify any complications
from it, such as kidney damage or damage to the eyes and nerves.
Control blood glucose levels with diet, medications, or insulin
as prescribed by your doctor.
Control high blood pressure with diet, exercise, and prescribed
Peritoneal dialysis—filtering the
blood by passing a solution into the abdomen, drawing wastes and excess water
from the blood through the peritoneal membrane (the lining of the abdomen),
which then acts as an artificial kidney
Hemodialysis—filtering the blood
by passing it through an artificial kidney machine
Kidney transplant—obtaining a healthy
and biologically compatible kidney from a living donor or someone who recently
American Diabetes Association800/DIABETES (342-2383)http://www.diabetes.org
National Institute of Diabetes & Digestive & Kidney Diseases800/891-5390http://www.niddk.nih.gov
National Kidney Foundation800/622-9010http://www.kidney.org
To find this and other Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient
Page on kidney failure was published in the December 12, 2001, issue.
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
Sources: National Institute of Diabetes & Digestive & Kidney
Diseases, National Diabetes Association, American Association of Diabetes
Topic: KIDNEY DISEASE
Parmet S, Lynm C, Glass RM. Diabetes and the Kidney. JAMA. 2003;289(24):3372. doi:10.1001/jama.289.24.3218