What Causes Diabetic Kidney Disease?

Diabetic kidney disease, also known as diabetic nephropathy, is one of the most common complications associated with diabetes. Onset of diabetic kidney disease usually occurs after several years of having diabetes. It is characterised by an increase in the amount of albumin, a protein, in the urine and a decrease in kidney function.

The exact cause of diabetic kidney disease is still unknown, but it is believed to be related to uncontrolled blood sugar levels in the bloodstream and other underlying conditions associated with diabetes, such as high blood pressure and high cholesterol.

When blood sugar levels remain high for extended periods of time, it can cause damage to the tiny blood vessels that normally filter the blood and help it to move through the body. Over time, this leads to reduced kidney function and can cause inflammation of the kidneys, as well as damage to other organs and systems in the body.

High blood pressure also plays a role in causing diabetic kidney disease as it can lead to a decrease in the filtration rate of the kidneys and ultimately cause damage to the vessels. In addition, those with poorly controlled diabetes are more likely to suffer from high cholesterol, which can also increase the risk of developing diabetic kidney disease.

There are also genetic factors that may play a role in the development of diabetic kidney disease. Those with a family history of the disease may be at increased risk if they suffer from diabetes as well.

To prevent kidney disease reaching later stages, it is important to regularly test urine for the presence of the albumin protein.

Lifestyle factors that increase risk

In addition to genetic and physiological factors, certain lifestyle choices can increase the risk of developing diabetic kidney disease.


Smoking cigarettes promotes inflammation and constricts blood vessels, which can accelerate kidney damage in people with diabetes. Several studies have found smoking to double or even triple the risk of developing kidney disease for those with type 1 or type 2 diabetes. Quitting smoking is one of the best things a diabetic can do to protect their kidney health.


Carrying excess weight places strain on the kidneys by increasing inflammation and vascular damage. Obese diabetes patients are up to 7 times more likely to develop kidney disease than normal weight patients. Losing weight takes pressure off the kidneys and can slow the progression of diabetic nephropathy. Even a 5-10% reduction in body weight can impart meaningful kidney benefits.

Alcohol consumption

Drinking more than moderate levels of alcohol can damage blood vessels and promote kidney inflammation. Studies show heavy alcohol consumption accelerates declines in kidney function in diabetics. Limiting alcohol intake to 1 drink per day for women and 2 drinks per day for men helps mitigate kidney harm.

High protein diets

Eating excessive dietary protein makes the kidneys work harder to filter waste products from protein metabolism. Over time this can contribute to kidney damage in vulnerable individuals. Diabetics should limit protein intake to no more than 20% of total daily calories for optimal kidney health.

Preventing progression

The onset of diabetic kidney disease cannot always be prevented, but progression to end stage kidney failure is avoidable in many cases through diligent disease management. Keeping blood sugar tightly controlled, maintaining healthy blood pressure levels, and adhering to kidney-friendly diet and lifestyle changes all help thwart advancing damage. Regular check ups also allow early intervention if kidney function begins deteriorating.

The best way to prevent the onset of diabetic kidney disease is to keep blood sugar levels under control and maintain control of other underlying conditions associated with diabetes, such as high blood pressure and high cholesterol. However, if you are already at risk for diabetic kidney disease, regular screening is important to catch any changes in kidney function before significant damage occurs.

Photo by Robina Weermeijer on Unsplash

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