Diabetes is a chronic condition that affects how the body processes blood sugar (glucose). Over time, high blood sugar levels can damage blood vessels and nerves throughout the body, leading to complications like kidney disease. When diabetes damages the kidneys, it is called diabetic nephropathy. This is one of the most common causes of kidney disease and kidney failure worldwide. The kidneys act as filters to remove waste and extra fluid from the blood. When the kidneys are damaged, they cannot properly filter the blood, causing waste to build up in the body. Detecting diabetic kidney disease early is crucial, as early treatment can help prevent further damage. But what is the most important early symptom to be aware of?
Increased Urination and Thirst
One of the first signs that diabetes is affecting the kidneys is increased urination and thirst. Excess sugar builds up in the bloodstream when diabetes is uncontrolled. The kidneys respond by trying to filter out the extra sugar through urine. This results in more frequent urination. The increased urination also leads to fluids loss, triggering thirst as the body tries to rehydrate itself. If you suddenly find yourself running to the bathroom more often and drinking more water than usual, diabetes may be damaging your kidneys.
However, increased urination and thirst alone are not enough to confirm diabetic kidney disease. These symptoms can also result from uncontrolled diabetes for other reasons. More specific symptoms are needed to pinpoint early kidney damage.
Foamy Urine
Foamy or bubbly urine can be an early sign of diabetic kidney problems. Normally, urine should be clear to pale yellow. But when protein leaks into the urine due to damaged kidneys, it can cause foam or froth to form. This symptom is known medically as proteinuria. Protein is not normally present at high levels in urine. Persistent proteinuria signals deteriorating kidney function due to diabetes. Even small increases in urinary protein should not be ignored, as addressing it early is key to preventing further kidney damage.
Blood in Urine
Another possible red flag is blood in the urine, also called hematuria. Healthy kidneys filter the blood without allowing red blood cells to pass into the urine. But damaged kidneys can allow red blood cell leakage, causing urine to range from pink to deep red in color. There are other causes of blood in urine besides diabetes, like infections, kidney stones or prostate problems in men. Still, any hematuria warrants medical attention to determine the underlying cause. Catching diabetic kidney issues early allows steps to be taken to protect remaining kidney function.
Swollen Feet and Ankles
Fluid retention causing puffy or swollen feet, ankles and legs can indicate that the kidneys are not properly filtering fluids. Excess fluid builds up in the body rather than being excreted through urine when the kidneys are impaired. Gravity causes this fluid to gather and pool in the lower extremities. There are other potential reasons for ankle and leg swelling beyond kidney problems, like venous insufficiency, medication side effects, or prolonged standing. Regardless, unexplained swelling should be evaluated promptly to identify the cause and administer appropriate treatment.
Fatigue and Weakness
Extreme fatigue, lethargy and generally feeling unwell or weak can signal kidney problems. Healthy kidneys make a hormone called erythropoietin that stimulates red blood cell production. Damaged kidneys make less of this hormone, leading to anemia or low red blood cells. With anemia, the circulation is deprived of oxygen-carrying red blood cells, resulting in exhaustion, weak spells, shortness of breath and generally feeling run down. Anyone with diabetes experiencing these symptoms should have kidney function assessed.
Poor Appetite and Metallic Taste
As kidney dysfunction progresses, it can lead to buildup of waste products in the blood. This causes symptoms like poor appetite, nausea and a bad metallic taste in the mouth. When the kidneys are failing, they cannot remove urea from the bloodstream properly. Urea breakdown can cause an ammonia-like taste or smell in the mouth. Bad breath may also occur. Anyone with diabetes who starts experiencing these symptoms should see a doctor to evaluate kidney health.
Difficulty Concentrating and Confusion
Advanced kidney disease allows dangerous levels of waste, toxins and electrolyte imbalances to accumulate. This can impair normal brain function, making concentration difficult and causing confused thinking. If kidney problems are left untreated, this may progress to seizures or coma. Anyone with diabetes experiencing brain fog, difficulty focusing, or confusion should be immediately evaluated for kidney disease.
Darkened Skin
Skin that seems to tan or darken for no reason can be an overt sign of advanced kidney failure in diabetes. This is thought to result from accumulation of waste products and medications in the blood. Darkened patches or streaks may appear on the neck or creases of the palms, and some people notice a darkening of freckles. Skin changes may also be accompanied by itching. Prompt kidney function testing is warranted if such skin discoloration appears.
Summary of Key Early Symptoms
– Increased urination and thirst
– Foamy or bubbly urine indicating proteinuria
– Blood in the urine, or hematuria
– Swelling in the lower legs and ankles
– Fatigue, weakness and anemia-like symptoms
– Poor appetite and metallic taste in mouth
– Difficulty concentrating or confused thinking
– Skin darkening or discoloration
When to See a Doctor
Anyone with diabetes who experiences these symptoms should seek medical care promptly. Early detection and treatment of kidney issues can make a big difference in preserving kidney function. Do not assume symptoms are just part of having diabetes or getting older. Be proactive about kidney health by getting checked annually and any time troubling symptoms emerge. A doctor can order important tests like:
– Urine albumin-to-creatinine ratio: This measures the amount of albumin protein leaking into the urine from damaged kidneys.
– Glomerular filtration rate (eGFR): This estimates how efficiently the kidneys are filtering wastes from the blood. It detects early kidney impairment.
– Urinalysis: This checks urine for blood, protein, white blood cells or other abnormal findings indicating kidney or urinary tract issues.
– Blood tests: These reveal electrolyte imbalances, anemia and other chemical changes linked to weakened kidneys.
Lifestyle Changes to Protect Kidney Health
If kidney disease is detected early in diabetes, progression may be slowed or halted by:
– Maintaining tight blood sugar control through diet, exercise, medication and regular testing
– Taking medications to lower high blood pressure and protect kidney vessels
– Restricting protein intake to take workload off the kidneys
– Staying well hydrated but avoiding excess fluids
– Controlling cholesterol levels through medication if needed
– Refraining from smoking and limiting alcohol intake
– Maintaining a healthy weight to avoid obesity-related kidney strain
Some people eventually require dialysis or a kidney transplant if disease progresses. But early detection and optimal diabetes management can prevent or delay the need for these treatments in many cases.
Conclusion
Increased urination and thirst are early tip-offs that diabetes may be affecting kidney function. But more specific symptoms like blood in the urine, ankle swelling, fatigue and skin changes provide clearer evidence that kidney damage is occurring and needs prompt attention. Catching it early and making appropriate lifestyle changes and treatment adjustments can help preserve remaining kidney function in diabetes. So be vigilant about possible kidney-related symptoms and get checked out right away if any strike you as troubling or persistent. Consistent monitoring, plus working closely with your medical team, offers the best protection against undiagnosed kidney problems threatening your health over time.