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Our Kidneys

By David Mendosa

Last Update: November 15, 2002

People with diabetes are so lucky. Because there are so many of us, lots of organizations and businesses have an interest in finding cures and treatments.

Because there are so many different complications of diabetes, organizations and businesses care about them too. One of the most common and serious of these complications is kidney disease.

Why do some of us get kidney disease?

The American Diabetes Association has by far the largest Web site dealing with diabetes, so it's not surprising that some of the best information that I have found about diabetes and kidney disease are just a couple clicks away from here. On the ADA's Web site, the page on Kidney Disease and tells me most of what I wanted to know.

These sites say that 10 to 21 percent of all of us with diabetes now have kidney disease. It is much more common among those who have type 1 diabetes than those with type 2.

Why do some of us get kidney disease and others apparently get off scot-free? The three main factors include one that we can't do anything about—genetics—and two that we can control—blood glucose and blood pressure.

"Tight blood sugar control reduces the risk of microalbuminuria [small amounts of protein in the urine] by one third," these pages say. "In people who already had microalbuminuria, the risk of progressing to macroalbuminuria was cut in half. Other studies have suggested that tight control can reverse microalbuminuria."

Even a small increase in blood pressure can quickly make kidney disease more serious. The first three or four ways to bring it down are losing weight, eating less salt, and avoiding alcohol and tobacco. If that's not enough, doctors may prescribe a low-protein diet or a drug that will help.

There is a lot more on-line help about diabetes and kidney disease on other Web sites. One of the best resources is the new Web site of the Kidney and Urology Foundation of America in New York City. The newly-designed version of this site went live October 1 and includes several excellent resources for us.

I spoke with Gregory J. Perrin, the foundation's national marketing and development director. "We cover a couple of hundred diseases and disorders—a constituency in this country that is represented by 70 million Americans," Greg says. "One in four people suffer some form of kidney or urologic disease each year."

He says that the Kidney and Urology Foundation is the first one in the country to link kidney disease and urology, although it is commonly linked in Europe. The foundation also brings together and serves all interested communities--scientists, researchers, health care providers, and consumers.

Currently, the site is up to 60 pages. Greg says that it is edited daily, something that I can vouch for. In our conversation I noted that one of the site's best articles about kidney disease and diabetes said that "Patients can remain stable in stage 2 without any symptoms of kidney disease for as long as 17 or more, depending on how carefully their blood pressure and blood sugar are controlled." The site had added the missing word—years—when I checked it the next day. 

The other first rate resource is a 12-page PDF (Adobe Acrobat file), Prevent Diabetes Problems: Keep Your Kidneys Healthy. The foundation credits the National Institute of Diabetes and Digestive and Kidney Diseases for this article.

This U.S. government site is another of our most important resources. You can read another version of the above article here, and another important one is Kidney Disease of Diabetes.

We have many other resources to turn to, including the Kidney Directions site that I wrote about a couple of years ago here. In large part we have these resources because there are so many of us. Personally, I'm thankful that I don't have a rare disease that few people have ever heard about and have no idea how to control. 

The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.

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