Kidney disease in diabetes mellitus
30-50% of patients with diabetes mellitus may develop kidney disease. Diabetes mellitus is now the more common cause of kidney failure requiring dialysis in Singapore. Kidney disease can be prevented.
Kidney disease in diabetes mellitus usually follows a set pattern. It begins with the appearance of small amounts of a protein called albumin in the urine. This is called microalbuminuria and can be detected using specialised tests. It is important to screen for this stage of diabetic kidney disease because aggressive treatment can normalise the kidney function at this time. Speak to your doctor about a test for urine microalbumin. As with eye disease, this stage of kidney disease produces no symptoms and you will not know you have it unless you test for it. This should be done at the time of diagnosis for type 2 diabetes mellitus and yearly thereafter. Those with type 1 diabetes mellitus can wait 3 years before doing their first test.
Later on, the amount of protein increases and patients reach a stage called nephrotic syndrome. This stage may be associated with swelling of the ankles or abdomen. As the disease progresses, the patient can eventually develop kidney failure. These later stages of kidney disease are not reversible, ie. Your kidneys cannot return to normal. However, treatment at this time can still slow down the progression of kidney disease. This is important as it will delay your requirement for dialysis, sometimes as much as 5-10 years.
Several factors are important in the prevention of kidney disease.