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Kristen Nichols HeitmanThis is a guest post by Kristen Nichols Heitman, MPH, an epidemiologist in the Rickettsial Zoonoses Branch in the Division of Vector-Borne Diseases in the National Center for Emerging Zoonotic and Infectious Diseases at the Centers for Disease Control and Prevention (CDC). She received a Master of Public Health (MPH) with a concentration in epidemiology from Georgia State University.

Each of your kidneys is about the size of a computer mouse and made up of millions of tiny filters called nephrons. Too much glucose, also called sugar, in your blood from diabetes damages your kidneys’ nephrons. If the nephrons are damaged, a protein called albumin, which you need to stay healthy, leaks out of your blood and into your urine. Damaged kidneys do not do a good job of filtering wastes and extra fluid from your blood. The waste and extra fluid build up in your blood and make you sick. This is the condition known as chronic kidney disease (CKD).

Diabetes is the most common cause of CKD in the United States and approximately one in three adults with diabetes has CKD. Also, the number of young people with type 2 diabetes is increasing; having diabetes for a longer time means more time to develop diabetes complications, including CKD. What’s even more alarming is CKD often develops slowly and with few symptoms, so many people don’t even realize they’re sick until the disease is advanced. If not treated, CKD gets worse and can lead to kidney failure, known as end-stage renal disease (ESRD), or stage 5 CKD. A person with ESRD will need regular dialysis or a kidney transplant to survive. Diabetes is the most common cause of ESRD, accounting for nearly 44 percent of new cases.

The only way to find out whether you have CKD is through specific blood and urine tests. Your doctor will ask for a sample of your urine to look for albumin. A high level of albumin in your urine may mean you have kidney disease. The urine sample is sent to a lab for a test that looks at the amount of albumin compared with the amount of creatinine, a waste product also in your urine. A urine albumin-to-creatinine ratio test result above 30 is a warning sign of kidney disease. You should have this test at least once a year. Monitoring levels of albumin in the urine is an important way to detect CKD in its early stages and take steps to slow its progression. Screening individuals at high risk for CKD—those older than 50 years; those with a history of diabetes; hypertension, or cardiovascular disease; and those with a family history of CKD, among others—may prevent or delay CKD and ESRD.

If discovered early, CKD can be treated by medication and lifestyle alterations. Proper treatment can slow down how quickly the disease progresses and minimize complications. If people with diabetes keep their blood sugar and blood pressure levels within safe limits, their risk of getting CKD can be reduced by 33–40 percent. The number of new cases of kidney failure in people with diabetes or high blood pressure declined by about 1 percent during 2010–2012. This decline may mean that people with those diseases are getting better treatments.

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The conclusions, findings, and opinions expressed by the author do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

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