“Your A1c is good. Your thyroid is fine. Your urine is high.” Said our diabetes nurse at a clinic appointment. His urine is high? What did that mean? Did it mean that he was spilling protein in his urine? My mind was spinning out of control but I tried not to show it.
Why do you get protein in your urine with diabetes?
My son had been living with diabetes for over 12 years, but he was still just 14. I also knew that there was a correlation between kidney disease and diabetes.
High blood glucose levels require the kidneys to filter too much blood. This extra work is hard on the filters. After many years of such a strain, the kidneys can start to leak and useful protein is lost in your urine.
When to check for protein.
People with type 2 diabetes are usually checked for kidney disease upon diagnosis. For those with type 1 diabetes, there may be a baseline taken at diagnosis but regular checks usually don’t begin until 5 years after diagnosis. Children with type 1 diabetes will have their urine randomly checked but regular screening does not normally happen until during puberty or 5 years after diagnosis.
How much protein in my urine is too much?
An albumin/creatinine ratio test is often done with your regular bloodwork. This checks to see if there is any protein in your urine. According to Diabetes Canada, if you have diabetes and show a result of 2.0 ( 30mg/dl) or higher, you could have some kidney damage.
If your urine shows an elevated amount in the random sample done with your bloodwork, your diabetes team may request that you do a 24-hour urine collection. This will give them a much better idea of whether or not there is any real damage or the first result was an anomaly.
Are there any symptoms to tell me of possible kidney damage?
My son was healthy. He had very good control for a teen. Wouldn’t we know if he had any kidney damage?
Not really. For most people there are no symptoms at all which is why it is important to have your kidney function checked regularly if you have diabetes. In some cases, a person can experience a buildup of fluids. They may be having issues sleeping, have a poor appetite, upset stomach, feel weak, and have difficulty concentrating.
How to prevent kidney damage?
The best way to prevent kidney damage is to maintain tight control.
Chronic high blood glucose levels do more than just narrow and clog the blood vessels in your kidneys. It can damage the nerves that carry messages between your brain and your bladder. The damaged nerves may no longer tell you when your bladder is full and the subsequent pressure from a full bladder can damage your kidneys.
High blood glucose levels also create a breeding ground for urinary tract infections. Sometimes the urinary tract infection can spread to the kidneys causing damage there as well.
How to treat kidney damage?
According to the UK’s National Health Services, the treatments will depend on the severity of the condition.
Small amounts of protein in your urine is called microalbuminuria. Treatment for microalbuminuria can range from lifestyle change to medications that are associated with high blood pressure and high cholesterol.
Larger amounts of protein are called macroalbuminuria. This can be much more serious. If the issue is not caught until you have reached the large stage, end stage renal disease may soon follow. Treatment for this could be dialysis or even a kidney transplant.
Despite my initial panic and my son reminding me that his grandmother had died of kidney failure, all was fine. He did a 24 hour urine collection and the results were perfectly acceptable.
When you live with diabetes it is important to regularly check on your eye health, your kidney health, your mental health, and of course your A1c.