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October 23, 2012 > Kidney Disease is a Major Complication of Diabetes

Kidney Disease is a Major Complication of Diabetes

Washington Hospital Seminar Focuses on Preventing Kidney Failure

Kidney disease is a serious complication of diabetes. In fact, more than one in three people with diabetes in the U.S. have chronic kidney disease, according to the Centers for Disease Control and Prevention. Kidney disease can lead to kidney failure, which can only be treated through dialysis or a kidney transplant.

"Elevated glucose levels caused by diabetes can damage the kidneys," said Dr. Lucia Yumena, a Fremont nephrologist and member of the Washington Hospital medical staff. "The longer you have diabetes, the greater your chances of developing kidney disease."

She will present "Kidney Disease: Risk Management and Beyond," on Thursday, November 1, from 7 to 8 p.m. Yumena will be joined by Anna Mazzei, a registered dietitian at Washington Hospital, who will talk about the role of diet in preventing kidney failure. The seminar is part of Washington Hospital's free monthly Diabetes Matters education series and will be held at the Conrad E. Anderson, M.D. Auditorium, 2500 Mowry Avenue (Washington West), in Fremont.

Diabetes occurs when the body does not produce enough insulin or is not able to use it properly. Insulin is a hormone needed to convert sugar, starches, and other food into energy. When this process doesn't work properly, glucose (sugar) levels in the blood can get too high.

Yumena will explain how diabetes affects the kidneys and ways to prevent kidney disease. Inside the kidneys are millions of tiny blood vessels that act as filters. They remove waste products from the blood.

"High levels of glucose in the blood causes the kidneys to get bigger and they filter too much blood," she said. "The kidneys get overworked and in time they start to lose their ability to filter the blood."

Early Stages

Kidney disease can be hard to detect in the early stages if you aren't looking for it, according to Yumena. There are usually no symptoms until the disease has progressed and the kidneys start to lose function. Symptoms include loss of sleep, poor appetite upset stomach, weakness, fatigue, and difficulty concentrating.

Kidney disease can be diagnosed through urine and blood tests. She said people with diabetes should get tested regularly so that kidney disease can be caught in the early stages.

"If kidney disease is diagnosed when the kidneys are still functioning, we can prevent kidney failure through medication and lifestyle changes," Yumena added. "But once you have chronic or end-stage kidney failure, there is no stopping the progression."

When the kidneys fail, they can no longer filter the blood, so harmful wastes, extra salt, and water build up in the body. The only options are a kidney transplant or dialysis.

There are two main types of dialysis, she explained. Hemodialysis filters the blood with the help of a machine while peritoneal dialysis uses the lining of the abdomen to filter the blood. Yumena said people with diabetes have to keep their blood glucose, blood pressure, and blood cholesterol levels under control to reduce their risk for kidney disease. High blood pressure contributes to kidney disease because it also damages the blood vessels in the kidneys. Diet, exercise, and medications can help people with diabetes manage these risk factors.

"Smoking is also a serious risk factor," she added. "You have to stay away from tobacco."

Diet Matters

Mazzei will talk about the importance of diet in keeping some of these risk factors under control to prevent kidney disease and stop the progression. People with diabetes need to control their carbohydrate intake to manage blood glucose levels and reduce their intake of salt and fat, especially saturated and trans fats, she said. To prevent complications, people with diabetes should eat a diet that includes the right amounts of fruits and vegetables, lean proteins, whole grains, and low-fat dairy products.

"Proper meal planning can help to reduce the risk for kidney disease," Mazzei added. "Once you have kidney disease, what you eat becomes even more critical. As the disease progresses, more diet restrictions are required, especially if a patient is on dialysis."

Meal planning can get complicated in the later stages of kidney disease, according to Mazzei. Protein, potassium, and phosphorous need to be controlled, but that can be difficult.

"Potassium is found mainly in fruits and vegetables," she said. "You need them for nutrition, but many are off limits. Protein is essential also, but you have to limit it. Once dialysis has started, liquids need to be controlled because the fluid can build up."

Mazzei said people with end-stage kidney disease need a medically indicated meal plan.

"The diet is very complex with end-stage kidney disease," she added. "It's not something you can go online and find. You need to work closely with a dietitian who specializes in kidney disease. The dietitian must pay attention to lab results and alter the meal plan accordingly. The best way to avoid this is to be diligent about your meal plan so you can prevent serious complications like kidney disease."

To learn about other diabetes programs at Washington Hospital, visit

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