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Learn about factors that can increase your risk of kidney disease, such as diabetes and high blood pressure
Diabetes mellitus, high blood pressure (hypertension), and reduced blood flow to the kidneys are the most common diseases that can affect the kidneys. Other factors that can lead to kidney disease include infections, autoimmune disorders, toxins, obesity, smoking, and cancer.
Kidneys are a pair of bean-shaped organs that filter waste or toxins from the blood and excrete them via urine. Additionally, they play a significant role in the maintenance of blood pressure, pH balance, and vitamin D metabolism.
Diabetes mellitus
Diabetes is one of the most common noncommunicable diseases that cause diabetic kidney disease or nephropathy.
The kidneys help manage blood pressure and produce hormones that the body requires to function properly. Diabetes causes damage to the small blood vessels. When this occurs, the kidneys cannot effectively function to clear blood of waste. This results in salt retention, leading to high blood pressure, weight gain, and accumulation of fluid in the tissues (edema).
Diabetes can cause nerve damage, which makes it difficult to empty the bladder. Accumulation of urine causes pressure to build up in the bladder, which causes damage to the kidneys. Furthermore, when urine is retained in the bladder for an extended period of time, it increases the risk of infection.
The presence of small amounts of protein in urine is the first symptom of diabetic nephropathy (microproteinuria). Kidney function diminishes when proteinuria and blood pressure rise.
Although diabetes can cause kidney damage that worsens over time, measures can be taken to delay renal deterioration or avoid kidney failure. Medications that help control diabetes and high blood pressure may be prescribed as a part of your treatment plan.
High blood pressure
High blood pressure can constrict the blood vessels, causing injury to the innermost blood vessel layer (endothelium). Blood flow to the kidneys is reduced as a result.
If the blood vessels in your kidneys are damaged, they may not function optimally and may be unable to eliminate wastes and excess fluids from your body. Extra fluid in the blood arteries can raise your blood pressure even higher, which further leads to kidney failure.
Lowering your blood pressure is the best way to slow or avoid kidney damage caused by high blood pressure. These measures involve a combination of medications and lifestyle adjustments.
Medications
- Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers decrease blood pressure and help protect the kidneys from further damage, particularly in people with diabetes.
- Diuretics to increase urination may also be prescribed.
- Typically, a combination of medications may be needed to keep your blood pressure under control.
Lifestyle changes
- Balanced diet (low in sodium and fat)
- Regular exercise
- Weight management
- Stress management
- Smoking cessation
Reduced blood flow
Reduced blood flow to the kidneys can lead to acute kidney injury and has the potential to cause kidney damage and kidney failure
Acute kidney damage occurs when your kidneys abruptly cease to function normally. It can range from mild renal dysfunction loss to total kidney failure. This type of kidney disease is typically found in the elderly who have other disorders that affect the kidneys.
Vascular conditions
- Renal artery stenosis: Refers to narrowing or blockage of a renal artery and has been linked to kidney failure and high blood pressure. Risk factors include:
- Age and sex (primarily affects men between ages 50-70)
- Smoking
- High cholesterol
- Diabetes
- Being overweight
- Family history of heart disease
- Renal artery thrombosis: Occurs when a blood clot forms in an artery that supplies the kidney, which obstructs blood flow and can lead to kidney failure.
- Renal vein thrombosis: Occurs when a blood clot forms in a vein that drains blood from the kidney.
- Atheroembolic renal disease: Occurs when a plaque fragment from a larger artery breaks off and travels through the blood, narrowing the renal arteries.
Heart failure
Heart failure is a significant risk factor for kidney disease. When the heart no longer pumps properly, it becomes clogged with blood, causing pressure to build up in the major vein and creating blood congestion in the kidneys. The kidneys are damaged by a lack of oxygenated blood.
Sepsis
According to the National Kidney Foundation, sepsis is one of the leading causes of acute kidney damage. Studies have shown that sepsis is responsible for 32%-48% cases of acute renal damage.
Sepsis can damage the kidneys in two ways:
- Starts as a kidney infection or bladder infection that moved to the kidney
- Starts a chain reaction that eventually causes kidney injury
Blood pressure drops drastically during sepsis and septic shock, which changes how blood flows through the body. Because blood cannot flow as quickly as it should, the supply of nutrients and oxygen to tissues and organs is reduced. At the same time, blood begins to clot within the arteries (disseminated intravascular coagulation), which further reduces blood flow.
Sepsis, like strokes or heart attacks, is a medical emergency that necessitates prompt diagnosis and treatment. Treatment is focused on treating the infection and any damage caused. If the kidneys are not operating efficiently enough to filter toxins and be excreted via urine, dialysis (an artificial method of filtering the kidneys) can be used to clear the blood.
What are complications of kidney disease?
Along with removing excess fluids and waste products from the body, the kidneys produce a hormone called erythropoietin that increases red blood cell production in bone marrow as a response to the lack of oxygen supply to the tissues. When kidneys fail to function properly, you are at a higher risk of developing the following conditions.
Anemia
Anemia is a common and serious complication of kidney disease. With anemia, all tissues receive less oxygen, resulting in reduced organ function. Anemia can potentially lead to:
- Fatigue
- Shortness of breath
- Feeling cold
- Dizziness
- Headaches
- Chest pain
- Memory issues
- Difficulty concentrating
- Rapid heart rate
Having kidney disease can even change the way iron is used by the body. You require more iron to produce the same quantity of hemoglobin compared to someone who does not have kidney disease.
Uremia
When the kidneys fail, waste products build up in the body, which can lead to uremia.
Uremia is a condition in which wastes accumulate in the blood. This can lead to increased blood ammonia levels, which damage the brain and pH balance of the body. Uremic encephalopathy is the accumulation of toxins in the brain and electrolyte imbalances can cause seizures or coma. Uremia can cause
- Nausea
- Vomiting
- Loss of appetite
- Unintended weight loss
Excess fluids
During the filtration process, the kidneys eliminate excess fluids and electrolytes, such as sodium and potassium, from the body. If the filtration process is disrupted, more fluid is retained in the body, causing swelling in the legs, ankles, feet, hands and face.
Fluid accumulation in the body can also cause shortness of breath, high blood pressure, and heart problems.
Changes in urination
Kidney disease can cause problems with urination, such as:
- Pain, pressure, or difficulty urinating
- Frequent urination (pale urine)
- Reduced urine output (dark urine)
- Blood in urine
- Cloudy urine
