Preventing Kidney Disease

According to the American Diabetes Association (ADA), 20%-30% of individuals with diabetes develop kidney disease. This is in spite of the fact that it's one of the most preventable of all the devastating complications of diabetes. The key is early detection. If it's detected in the earliest stages, kidney dysfunction can be stopped or reversed with treatment. The best way to assure early detection is by doing a urine test that measures the levels of a protein called microalbumin.

Why Diabetes Damages Kidneys

When our bodies digest the protein we eat, the process creates waste products that build up in the blood. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes and become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter so they stay in the blood.

However, when blood sugar levels get too high, it can cause damage to the filters. This puts extra strain on the kidneys and after many years, they start to leak useful protein into the urine. Having small amounts of protein in the urine is called microalbuminuria. Having larger amounts is called proteinuria or macroalbuminuria.

Over the course of time, some of the filters in the kidneys may collapse if the strain continues to be too great. As the capillaries lose their filtering ability, waste products start to build up in the blood. Finally, the kidneys fail. This failure is called end-stage renal disease (ESRD). ESRD is very serious. A person with ESRD needs either to have a kidney transplant or to have the blood filtered by machine (dialysis).

Microalbumin Testing

Early detection is the key to preventing kidney disease. There are no symptoms in the earliest stages, so it's vital to test for microalbuminuria on a regular basis. The American Diabetes Association (ADA) and the American Kidney Foundation (AKF) recommend that everyone with diabetes be tested for microalbuminuria annually. However, studies have shown that only one out of every 10 patients with diabetes has a microalbumin test done annually. This is due to a number of reasons including a lack of awareness about the importance of the test and the inconvenience of the traditional 24-hour urine collection required by traditional laboratories.

Clearly, if you have diabetes, it's worth having a yearly microalbumin test in order lower your risk of developing kidney disease.