The Sunday News
By Roselyn Kapungu
Did you know that if you have Type 2 Diabetes (adult onset) there is a more than a 30% chance you might have kidney disease? According to the Centers for Disease Control and Prevention, diabetes is the leading cause of kidney disease.
Diabetic Kidney Disease, also called Diabetic Nephropathy, is a type of kidney disease caused by diabetes – this article will refer to diabetic nephropathy as simply ‘kidney disease’. The Zimbabwe Diabetes Association estimates diabetes prevalence in adults in Zimbabwe at almost 10%. The increasing prevalence of diabetes in Zimbabwe, coupled with the life-threatening nature of kidney disease, presents a significant challenge. Renal failure (kidney failure) is the 11th cause of mortality in Zimbabwe (Ministry of Health and Child Care, 2014). While not all people with kidney disease will reach end-stage renal failure, this ranking highlights a critical need to address the risk factors for diabetics developing kidney disease.
A few months ago, my father became seriously ill – he drastically lost weight and in a few short weeks his health deteriorated badly. The doctor told him he had a urinary tract infection and prescribed 10-days’ worth of antibiotics. There was no change after another two weeks. Another doctor’s visit recommended more tests and another round of antibiotics. In all, it took three months for my father to be told his kidneys were damaged and not working properly – and even though it has been six years since he was diagnosed with diabetes – we had not in that whole period, known that diabetes can cause kidney disease.
Diabetes causes kidney disease when too much sugar in the blood hurts the blood vessels in the kidneys called glomeruli which help clean the blood. When one has diabetes, their blood sugar is too high because the body does not make or use insulin in the way it should. Insulin is a hormone made in the body to help turn sugar from food into energy and when the body does not use insulin the way it should, too much sugar stays in the blood – and this hurts the kidneys.
Fore-warned is fore-armed
Sadly, when I look back on this seemingly short period, I can’t help but think how the situation could have potentially been different had we known and been mindful of the diabetes – kidney disease link early on. Without knowing about this link, it is difficult to try and control diabetes’ impact on kidney disease. A key challenge is that Chronic Kidney Disease often develops slowly and with few symptoms in its earlier stages. Many people don’t realize they’re sick until the disease is advanced.
My take from this experience is that if you have diabetes, you need to get your kidneys checked regularly – even when you are not experiencing any symptoms. This can be done through regular blood and urine tests which can help identify kidney disease in its early stages and enable you to get early treatment and make the necessary lifestyle changes. Urine tests check for Albumin, a protein found in the blood, and when there is too much albumin in your urine it is likely showing kidney damage – a damaged kidney lets some albumin pass into the urine.
Blood tests to check how well your kidneys are filtering your blood, estimate your Glomerula Filtration Rate (eGFR), which also allows doctors to determine the stage of kidney disease. Having this information will help you to take actions that may limit the progression of kidney disease. These include controlling your levels of blood glucose and blood pressure and maintaining healthy lifestyle habits such as not smoking, eating healthy and being physically active, among others.
Managing your diabetes and related risk of kidney disease is all the more important in a country like Zimbabwe where the costs of kidney disease treatment, are very high. Once you reach end-stage kidney disease you will require kidney dialysis or a kidney transplant. Kidney dialysis – a process that may be needed two or three times a week – involves a dialysis machine removing waste products and extra fluid from your blood as the kidneys can no longer perform this function. A kidney transplant involves surgically placing a healthy kidney from a donor (either from a deceased or living donor) into your body. These are both expensive treatments and are beyond the reach of many in Zimbabwe.
A friend once told me that her father had succumb to kidney failure, sadly, without their knowledge that he had been living with chronic kidney disease. It was heart-breaking to hear her say, “no wonder my dad allowed nature to take its course. He felt so bad burdening us. How are people managing with such costs veduwe?”
About the author
Roselyn Kapungu has been living with Lupus since 2014 and is actively engaged in raising awareness on lupus and other autoimmune diseases. Kidney disease awareness is important to her as one in three people with Lupus will get kidney disease in the course of their illness. Additionally, her mother passed from kidney failure and her father, a diabetic, is currently living with Stage 3 kidney disease. While her primary aim is to raise awareness, it is important to note that the information provided in this article does not constitute professional medical advice or basis for diagnosis. Please consult your doctor if you have concerns about diabetes and kidney disease.