Diabetes affects many organs of the body including the kidneys. Kidney damage and bladder problems are long-term complications that may affect people with diabetes. Diabetic kidney disease (also called diabetes nephropathy) can lead to kidney failure.

Bladder infection signs include:

pain or burning when urinating
an urgent need to urinate often
cloudy or bloody urine

Call your healthcare provider if you have any signs of kidney infection described below:

back pain
chills
fever
ketones in urine

Diabetes is the leading cause of kidney failure, accounting for about 40 percent of new cases. Early treatment with ACE-inhibitors -- drugs that lower blood pressure -- help prevent kidney failure and using these drugs may help prevent half the cases according to research from the Centers for Disease Control & Prevention (2001).

The kidneys keep the right amount of water in the body and help filter out harmful wastes. These wastes, called urea, then pass from the body in the urine. Parts of the kidneys that filter out wastes can be damaged by diabetes. Kidney failure (also referred to as end-stage renal disease [ESRD] or nephropathy) leads to a person needing their blood filtered through a machine (this treatment is called dialysis) several times a week or needing to have a kidney transplant.

Diabetes is the leading cause of treated ESRD, accounting for 43 percent of new ESRD cases (NIH/NIDDK, 2000). Most people with diabetes do not develop nephropathy that is so severe as to cause ESRD. Native Americans and African Americans are two racial groups who are at higher risk for developing ESRD. Heredity, diet, high blood pressure, high blood sugar, and not following your healthcare provider's recommendations are a few factors that lead to diabetic nephropathy.

Health care providers can learn how well the kidneys are working by testing for microalbumin (a protein) in the urine. Microalbumin in the urine is an early sign of diabetic kidney disease.

Taking charge of diabetes can help prevent kidney damage. This includes controlling blood glucose and keeping blood pressure under control. The box below highlights some key target goals.

Preventing kidney or bladder damage

To prevent kidney damage (nephropathy) or
bladder damage, people with diabetes should watch for the following risks:

High blood pressure -- goal should be <130/80 mmHG
Protein in urine (microalbumin) -- have a doctor or health care professional check for this yearly
High blood sugar -- ask doctor to define your healthy goal range (<126 mg/dl)
High Hemoglobin A1C -- goal should be <7

Helpful web sites:

National Institute of Diabetes & Digestive & Kidney Diseases

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