Diabetes is the leading cause of chronic kidney disease: Mayo Clinic explains the connection. An excess of glucose in the blood can damage the kidneys and lead to chronic kidney disease. In these cases, the kidneys cannot effectively perform their most important function: regulating the composition of the blood by filtering waste and maintaining the balance and amount of salt and water in the body. Chronic kidney disease may be advanced before symptoms appear and people are diagnosed. It can progress to end-stage kidney failure, which can be fatal without dialysis or a kidney transplant. Both type 1 and type 2 diabetes can cause chronic kidney disease, although type 2 diabetes is a much more common cause. «The presence of a high concentration of glucose causes chemical changes that lead to the appearance of protein in the urine, and that presence directly activates factors that cause scarring and fibrosis within the kidney, which leads to the worsening of kidney function.» The way diabetes and chronic kidney disease overlap and interact is complex. One of the most serious complications is chronic kidney disease. Ivan Porter II, M.D., a nephrologist at Mayo Clinic in Florida, explains the connection between diabetes and chronic kidney disease. Global statistics show that up to 40% of people with diabetes develop chronic kidney disease, also known as chronic kidney failure. At this point, it is necessary to perform dialysis or a kidney transplant. Most often, chronic kidney disease is diagnosed at stage 3 or later stages. «The presence of other comorbidities, such as uncontrolled high blood pressure, uncontrolled diabetes, or the presence of protein in the urine, can make what seems like an early stage worse for a person,» says Dr. Porter. Not all people living with diabetes will develop chronic kidney disease. At the same time, the decline in kidney function related to chronic kidney disease can lead to insulin resistance, which in turn can cause type 2 diabetes. The stages of kidney disease are: • Stage 1. In this stage, the GFR is 90 or above, which is considered a healthy level. • Stage 2. In this stage, the GFR is between 60 and 89. • Stage 3. This stage is divided into two subtypes — stage 3a and stage 3b. In stage 3a, the GFR is between 45 and 59, and there is mild or moderate impairment of kidney function. In stage 3b, the GFR is between 30 and 44, and the impairment of kidney function is more severe. • Stage 4. The GFR is between 15 and 29, and the kidney impairment is severe. • Stage 5. This stage is considered end-stage kidney disease, also called kidney failure. The GFR is less than 15. Dr. Porter notes that it is essential to control diabetes, periodically monitor kidney function, and take steps to protect kidney health in order to reduce the risk. Controlling diabetes includes managing medication, developing a healthy eating routine, exercising, and planning for factors that can affect blood sugar levels, such as illnesses, stress, and hormonal changes due to menstrual cycles, perimenopause, and menopause.
