Most diabetics are aware that diabetes affects their kidneys, but few actually know how diabetes affects them. Diabetic kidney disease (renal or diabetic nephropathy) occurs over a long period of time as a result of the complications of diabetes. High blood pressure and high blood sugar levels are among the primary causes of those complications. Unfortunately, if diabetic control is not well maintained, kidney damage is likely taking place with no symptoms. Diabetic kidney disease is preventable. But it is essential that action be taken immediately to prevent any further damage. After all, when the kidneys fail, life itself will end.

The kidneys perform a number of functions in the body. They filter the blood to remove substances that should not be there, they regulate the amount of blood circulating throughout the body, they contribute to the control of blood pressure by producing specialized hormones that cause blood vessels to restrict, they synthesize certain proteins and they produce urine to allow for the discharge of undesirable substances. The kidneys receive their blood supply directly from the heart, in fact they filter about 25% of the blood pumped by the heart. The kidneys filter the body's total blood supply numerous times throughout each day. This article will provide a simplified version of how the kidneys function, and how the complications of diabetes impact the kidneys. A more detailed version of how they function and diabetic impact is available in the Diabetics Handbook (see below)

The kidneys (there are two kidneys) contain about one million small tubular filters called nephrons each. They protrude outward into the blood supply inside the kidneys, as it is pumped through. Blood pressure forces blood through the outer membranes of the nephron filters. Once inside, millions of specialized cells capture desirable substances, such as natural forms of vitamins and minerals, and push them back through the membranes of the filters and back into the main blood supply. The substances that these specialized cells allow back into the bloodstream are very limited. Each type of specialized cell is limited to a narrow range of substances that they can reintroduce. Foreign substances, such as a chemical, will be retained and passed out of the kidneys in urine to the bladder where it is discharged. The adrenal glands play a major role. The amount of sodium in the bloodstream is monitored by the adrenal glands. There are two adrenal glands, one on top of each kidney. When the sodium levels are too high or too low they signal the kidneys to modify how much sodium is maintained in the system.

High sodium levels will trigger thirst. When large amounts of water are consumed, the sodium content of the blood is diluted as the water is drawn into the bloodstream. When the dilution reaches a particular point, the kidneys will receive signals to open cells in the outside of the nephrons to allow more blood to enter. The plasma will be removed from the excess water. The plasma will be returned to the bloodstream, and the excess water and some sodium will be discharged with the urine. The result will be a normalized concentration of sodium in the bloodstream. That explains why after drinking a large amount of fluid, the need to urinate will follow shortly thereafter.

When blood sugar levels increase, the viscosity of the blood increases, which means that it becomes thicker. Some experts claim that when the blood sugar level reaches 200 mg100ml., the viscosity approaches that of syrup. The filtration cells and membrane of the nephrons are very small. When the body attempts to force the blood through the filters it encounters problems. The kidneys will constrict blood vessels to increase blood pressure if more pressure is needed. However, the overall efficiency of the kidneys will be impaired. High blood pressure slowly causes the holes in the filters to increase in size. Other causes of high blood pressure will have the same result. When the holes in the filters increase in size, larger molecules (proteins) can pass through the filters, resulting in proteins in the urine. Also, when the muscle tissues burn glucose for energy, they discharge waste products (creatinine) into the bloodstream. The kidneys, under normal circumstances, will synthesize most of these waste products. When the filter holes are increased, these larger molecules will pass through the filters along with proteins into the urine. Doctors test the urine for signs of proteins and cratinine, which signifies that damage to the filters has occurred. The amount of these products in the urine can signify the amount of damage that has occurred.

Processed foods contain synthetic substances that are intended to improve color, taste, smell, texture and shelf life. These substances are converted by the body into AGE's (advanced glycosylation end products). AGE's accumulate in the body's tissues and joints. They are now credited with contributing heavily as a cause of over 30 chronic diseases, including diabetes. They also react with proteins and build up in the walls of vessels in the kidneys. They cause the filter holes to increase in size with the same result previously described.

Since the kidneys each have a million of these filters, symptoms will not develop until the problem has reached a critical phase. Damage to the kidneys is progressive, and irreversible. If action is not taken early to prevent the complications that cause kidney damage, the damage will continue to progress. There are direct actions that diabetics can take to curb the development and progression of kidney damage. Dietary changes can stop the buildup of AGE's, help control sodium levels and blood pressure. There are foods that can improve kidney function, protect the kidneys, aid in controlling blood pressure and glucose levels, and cleanse the kidneys. Like any other filter, the kidney's filters need to be routinely cleaned in order to function properly.

To learn more about how to care for the kidneys, how to cleanse them, as well as extensive coverage of other vital information about caring for diabetes, go to diabeticshandbook for a free preview.


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