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JAMA Patient Page
June 25, 2003

Diabetes and the Kidney

JAMA. 2003;289(24):3372. doi:10.1001/jama.289.24.3218

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 medication.

  • Exercise regularly.


  • 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 died



To find this and other Patient Pages, go to the Patient Page link on JAMA's Web site at 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 Educators