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Both types of diabetes can lead to kidney disease, but type 1 diabetes is more likely to lead to kidney failure. Diabetes is the most common cause of kidney failure, accounting for more than 40 percent of new cases.
Each year in the United States, nearly 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of a slow deterioration of the kidneys, a process known as nephropathy.
The kidneys act as filters to clean the blood. They get rid of waste and extra fluid. The tiny filters throughout the kidneys are called glomeruli.
When kidneys are healthy, the arteries brings blood and waste from the bloodstream into the kidney. The glomeruli clean the blood. Then waste and extra fluid go out into the urine through the ureter. Clean blood goes out of the kidney and back into the bloodstream through the veins.
Diabetic kidney disease takes many years to develop. In some people, the filtering function of the kidneys is actually higher than normal in the first few years of their diabetes. This process has been called hyperfiltration.
Over several years, people who are developing kidney disease will have small amounts of the blood protein albumin begin to leak into their urine. At its first stage, this condition has been called microalbuminuria. The kidney's filtration function usually remains normal during this period.
As kidney disease progresses, more albumin leaks into the urine. Various names are attached to this interval of the disease, such as overt diabetic nephropathy or macroalbuminuria. 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.