What is diabetic kidney disease ( Diabetic nephropathy) ? Diabetic nephropathy is the medical word for kidney problems caused by diabetes. It is estimated that diabetic nephropathy develops in approximately:

• 30-40% of patients with Type 1 diabetes
• 5-10% of patients with Type 2 diabetes

Diabetic kidney disease (diabetic nephropathy) is common in long standing diabetics especially in those with poor control of the condition. Diabetes damages blood vessels throughout the body and this includes the kidney. Diabetic nephropathy occurs in both types of diabetes - the insulin requiring (type I) and the non-insulin requiring (type II) diabetics. The occurrence of high blood pressure in diabetics is a strong predictor for diabetic nephropathy. For those with existing diabetic nephropathy, uncontrolled blood pressure will aggravate and hasten the progression of this disease to end-stage kidney failure. It is the commonest cause of end stage kidney disease in many countries.

What are the functions of the Kidney?

In order to understand what problems diabetic kidney disease can cause, one must have some basic knowledge about the kidneys and what their function is in the body.

The kidneys are the master chemists of the body. Normally, there are two of them, one on either side of the spine under the lower ribs. They are reddish brown in colour and shaped like kidney beans. Each kidney is about the size of your clenched fist. Many other organs depend on the kidneys in order to work properly.

Close up, the parts of the kidneys are shown below. Each part has a distinct role to play.

The main job of the kidneys is to remove wastes from the blood and return the cleaned blood back to the body. Every minute, about one litre of blood (one fifth of all the blood pumped by the heart) enters the kidneys through the renal arteries. After the blood is cleaned, it flows back into the body through the renal veins.

One can well imagine how hard the kidneys work!

Healthy kidneys do three essential things. Besides removing the wastes from the body via the urine, they regulate the levels of water and different minerals needed by the body for good health. They also produce hormones that control other body functions. In fact, many other organs depend on the kidneys in order to work properly.

Inside each kidney there are more than one million tiny units called nephrons. Each nephron is made up of a very small filter called a glomerulus, which is attached to a tubule.