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Understanding Diabetes

Anyone who has diabetes or high blood pressure should be aware that these conditions can lead to chronic kidney disease, and even to kidney failure. In fact, diabetes is the leading cause of kidney failure, and high blood pressure is the second leading cause. Diabetes and high blood pressure account for 70 percent of all cases of kidney failure in African Americans, and African Americans are four times more likely than whites to experience kidney failure.

The good news is that kidney failure doesn’t happen overnight. Instead, it usually occurs only after kidney damage has taken place over years, or even decades. By taking some precautions and monitoring your health, you can greatly reduce your risk of kidney failure.

Your Kidneys

Most people don’t stop to think about their kidneys, yet life depends on them. These fist-sized organs are located on either side of the spine at about waist height, and they play a crucial role in maintaining health.

One vital function of the kidneys is to filter waste products from the blood. Every two minutes, the body’s entire blood supply circulates through the kidneys, where the blood is filtered. Cleansed blood flows back to the heart, and waste products are filtered out into the urine.

In addition to filtering waste, the kidneys control the amount of fluid in the body, help regulate blood pressure, and aid in production of red blood cells and healthy bones.

Chronic Kidney Disease and Kidney Failure

Both diabetes and high blood pressure can damage the kidneys, which can lead to chronic kidney disease. Chronic kidney disease is a condition in which a person’s kidneys are not working as well as they should.

Eventually, the damage from chronic kidney disease can lead to kidney failure. When a person has kidney failure, it means their kidneys are not working well enough to keep the person alive, and the only options are dialysis treatment or a kidney transplant.

More than 7.4 million adults in the United States over age 20 have chronic kidney disease. That’s 4.5 percent of the population. There are currently 400,000 Americans who have progressed to kidney failure and are being kept alive through dialysis or kidney transplants.

More than 75,000 people die from kidney failure each year. Kidney disease is America’s ninth leading cause of death. With early diagnosis and treatment, chronic kidney disease can be slowed and kidney failure may be avoided. Without treatment, chronic kidney disease can become kidney failure with little or no warning.

Symptoms and Screenings

Early chronic kidney disease usually has no symptoms. Chronic kidney disease sometimes develops so slowly that many patients don't realize they are sick until the disease is advanced and they are rushed to the hospital for life-saving dialysis. The only way to find out if you have chronic kidney disease is to have some simple medical tests.

Sometimes there are warning signs of chronic kidney disease, especially when you are approaching kidney failure. The warning signs include:

• Swelling of parts of the body like the ankles, feet or face
• Burning or unusual sensation during urination
• Foamy, bloody or coffee-colored urine
• Urinating more often, especially at night
• Easy bruising or bleeding
• Listless or tired feeling

You should be tested for chronic kidney disease if you have experienced any of the above symptoms, or if you are diabetic, have high blood pressure, or have a family member who has experienced kidney disease. Remember, you can feel perfectly fine and still have chronic kidney disease.

The simple tests for chronic kidney disease include a urine test for protein and a blood test for creatinine. Your doctor will use these tests to figure out a number called your GFR (glomerular filtration rate). The GFR number measures how well your kidneys work. Your doctor should be able to explain exactly what your GFR number means.


The treatment goal for a person with chronic kidney disease is to slow down or stop the damage to the kidneys. It is very important for a person with chronic kidney disease to control their blood pressure, control their blood sugar if they are diabetic, avoid certain medicines, and follow a special diet that a doctor or dietitian can explain.


You can lower your risk of chronic kidney disease and kidney failure by living a healthy lifestyle: eat low-fat, low-salt foods, exercise regularly, limit alcohol intake and don’t smoke.

Another aspect of prevention is to get regular medical check-ups, which include screening for diabetes, high blood pressure and chronic kidney disease – even if you feel fine!

If you have high blood pressure, take your medicine faithfully and see your doctor often.

If you have diabetes, follow your diet, take your medication and test your blood sugar regularly.


The American Kidney Fund provides direct financial assistance to kidney patients in need and education for those with and at risk for kidney disease.. For more information, visit, call our nationwide toll-free “Help Line” at 800-638-8299 or e-mail

Tamara Ruggiero is Director of Communications for the American Kidney Fund.

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