Diabetes and the Kidneys

Basically, the function of the kidneys is to excrete urine - as usual, it is not that simple.  The kidneys are shaped somewhat like a kidney bean.  You have two of them - one on each side - just above the waist and behind the abdomen.  You can live a healthy life with only one kidney.  Some people are born with only one kidney.
The kidneys are the body's natural filtering and waste system.  These relatively small organs receive about 25% of the blood pumped from your heart.  The kidneys quickly put all but a small fraction of that fluid back into circulation. 
The heart is located behind and slightly left of the breastbone.  The heart and kidneys work together to control blood pressure.  High blood pressure makes the heart work harder resulting in damage to blood vessels throughout the body.  When blood vessels in the kidneys are damaged they will stop removing waste and extra fluids from the body.  The extra fluid in the vessels will raise blood pressure higher - becoming a dangerous cycle. 
High blood pressure is one of the leading causes of kidney failure.  Blood passes through a system of tiny filters in the kidneys every time the heart beats.  This filtering process occurs in millions of tiny filters called glomeruli, which are made up of capillaries (blood vessels that connect arteries with the veins).  As blood flows through the capillaries, the body waste is filtered out into the urine and is passed out of the body through the bladder.  The cleaned blood goes out of the kidneys and back into the bloodstream through the veins.
Protein and glucose (sugar) are supposed to be retained, not flushed out of the body.  If you are a diabetic and and your blood sugar is running high, over time this can damage the kidneys. 
When small blood vessels in the kidneys become clogged, that starts to interfere with the filtering process.  When the kidneys have almost stopped filtering waste out of the blood, you will have renal failure.  At first, kidney damage may be seen by small amounts of protein, called albumin, in the urine.  Damaged kidneys start to leak more protein out out through the urine, preventing waste and extra fluid from being removed.  You will have Diabetic Neuropathy when kidney damage becomes renal failure.
In order to treat high blood sugar, you may be prescribed different combinations of diabetic medications, diet and exercise.  Your doctor may also want you to take a blood pressure medication like an ACE inhibitor or Angiotensin Receptor Blocker (ARB's) to slow down kidney damage.  Once you have kidney damage you can't undo it but you can slow down, and possibly stop, the progress of the disease.
One way to evaluate kidney function is through measurement of serum creatinine.  Creatinine is the end product of creatine netabolism, which the kidneys cleanse from the blood.  Rising blood creatinine, which is an alkaline composition of urine and blood, happens when the kidneys have trouble cleansing the blood.  When the kidneys cannot cleanse the blood, toxins in the blood reach a critical level and you may require dialysis or a transplant.
Contact your doctor right away if you think you have a bladder or kidney infection.
Symptoms:

• Cloudy or bloody urine
• Pain or burning when you urinate
• An urgent need to urinate more and more often
• Fever or a shaky feeling
• Pain in your back or on your side below the ribs

As the infection gets worse, you may have chills, immense pain, and generally feel horrible all over.
To help prevent or delay kidney disease:

• Control your blood sugar
• Control your blood pressure
• Quickly treat any urinary infection
• Avoid medications that may further damage or hurt the kidneys: unless prescribed by the doctor - Ibuprofen, acetaminophens (Tylenol, Advil, miscellaneous pain medications, etc.) - especially if you are already taking a water pill
• Exercise regularly: exercise to control your weight, bend, stoop, reach and move easily - Do sustained rhythmic movement of arms and legs for Cardiovascular
• Do not smoke
• Do not drink alcohol
• Choose a healthy diet - if you are already having kidney problems , large amounts of protein, sodium, and potassium are not healthy.  You might be put on a low-salt diet because salt makes you retain water and raises the blood pressure.

Having diabetes doesn't necessarily mean you will have kidney disease, but you are at a greater risk.