Diabetes: The Most Common Cause of Kidney Failure
Local Nephrologist to discuss Diabetes Prevention & Treatment
at Doctors Hospital’s Free Public Health Lecture

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Each year in the Bahamas, there are growing numbers of people diagnosed with kidney failure, a serious condition in which the kidneys unsuccessfully rid the body of wastes, also known as Nephropathy.  Kidney failure is the final stage of a slow deterioration of the kidneys.

Diabetes, the most common cause of kidney failure, accounts for more than 40 percent of all new cases. Even when drugs and diet are able to control diabetes, the disease can lead to nephropathy and kidney failure. Although most people with diabetes do not develop nephropathy severe enough to cause kidney failure, many persons are living with kidney failure as a result of diabetes.

People with kidney failure have two options for treatment, dialysis, which substitutes for some of the filtering functions of the kidneys, or transplantation to receive a healthy donor kidney.

Persons of African descent develop diabetes, nephropathy, and kidney failure at rates higher than average. Scientists have not been able to explain these higher rates. Nor are they able to explain fully the relationship of the factors leading to diabetic nephropathy.  These factors include heredity, diet, and other medical conditions, such as high blood pressure. They have however found that high blood pressure and high levels of blood glucose increase the risk and that a person with diabetes will progress to kidney failure unless otherwise managed.

There are two types of diabetes, Type 1 and Type 2.  In patients with either type, the body does not properly process and use food. The human body normally converts food to glucose, the simple sugar that is the main source of energy for the body's cells. To enter cells, glucose needs the help of insulin, a hormone produced by the pancreas. When a person does not make enough insulin, or the body does not respond to the insulin that is present, the body cannot process glucose, and it builds up in the bloodstream. High levels of glucose in the blood lead to a diagnosis of diabetes. Both types of diabetes can lead to kidney disease but Type 1 diabetes is more likely to lead to kidney failure. Twenty to 40 percent of people with Type 1 diabetes develop kidney failure by the age of 50. Some develop kidney failure before the age of 30.

Over several years, people who are developing kidney disease will have small amounts of the blood protein albumin begin to leak into their urine.  As the disease progresses, more albumin leaks into the urine, as the amount of albumin in the urine increases, filtering function usually begins to drop. The body retains various wastes as filtration falls. Creatinine is one such waste, and a blood test for Creatinine can measure the decline in kidney filtration. As kidney damage develops, blood pressure often rises as well.

Overall, kidney damage rarely occurs in the first 10 years of diabetes, and usually 15 to 25 years will pass before kidney failure occurs. For people who live with diabetes for more than 25 years without any signs of kidney failure, the risk of ever developing it decreases.

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