Last updated: Apr 15, 2008

Kidneys are important because they remove waste products and extra water from the blood through the urine. They also regulate the body's salt, potassium, and acid content.



People with diabetes are at greater risk for kidney problems, including a condition called diabetic nephropathy. It's the leading cause of kidney disease and total kidney failure in the U.S., according to the National Institute of Diabetes and Digestive and Kidney Diseases.

The first sign of kidney damage is often protein in the urine; you should have your urine tested for albumin, a type of protein sometimes referred to as microalbumin. If you do have protein in your urine, there are many things you can do to prevent the kidney damage from getting worse.

Diabetic nephropathy is the result of the toxic effects of high blood sugar, including damage to the capillaries in the kidney, says Thomas Hostetter, MD, chief of the nephrology division at Montefiore Medical Center and Albert Einstein College of Medicine in the Bronx, N.Y., and chair of the American Society of Nephrology's Chronic Kidney Disease Advisory Group.

But not everyone with diabetes develops kidney disease. In the U.S., between one in five and one in 10 diabetes patients has nephropathy, according to the American Diabetes Association (ADA). And for reasons that are not entirely clear, certain ethnic groups, including African Americans, Hispanics, and Native Americans, appear to be at greater risk.

African Americans and Native Americans are also more likely than those in other ethnic groups to have hypertension, "which is a strong predictor of kidney damage," says Ian H. de Boer, MD, an assistant professor of medicine in the division of nephrology at the University of Washington in Seattle.

"The practical message is that everybody needs to be screened for kidney disease and treated based on their screening results and, if anything, that applies even more so to a minority population."