Kidneys have very important functions in the body. They remove toxins and wastes from the blood, while taking care of the balance of water and important minerals and electrolytes that your body needs to stay healthy.
Anyone who suffers from diabetes can run a higher risk of chronic kidney disease (CKD), which refers to the gradual loss of kidney functions. CKD can progress to end-stage kidney disease, which is a life threatening condition if dialysis or kidney transplantation is not carried out.
Read on to find out what you need to know about diabetes and dialysis treatments for your kidneys.
How does diabetes affect my kidneys?
One side effect of diabetes is that it injures small blood vessels throughout the body, including those found in the kidneys1.
When blood vessels in kidneys are injured, your kidneys may not be able to clean your blood as effectively as before, thus causing water and waste to build up in your bloodstream. This poisonous build-up of waste products is called uremia2 and can harm your body. Uremia can also cause nausea, vomiting, abnormal bleeding, shortness of breath and heart problems.
To get rid of the toxic build-up, the patient will need to go for regular dialysis sessions, so that the waste products in the bloodstream and excess water can be filtered out.
What is dialysis?
Dialysis is an artificial filtering procedure which acts like the normal kidney to remove and reduce the amount of water in your body, as well as the waste products that have built up in the blood.
There are two types of dialysis treatment – hemodialysis and peritoneal dialysis.
Hemodialysis (HD) is the process of removing toxins and excess fluid from the body by continually circulating the blood through a filter called dialyzer3. This filter is used with a dialysis machine three to four times a week.
In peritoneal dialysis (PD), the abdominal cavity (which houses most of your vital organs) is filled with a cleansing solution called dialysate4, commonly known as the dialysis fluid.
The walls of the abdominal cavity are lined with a membrane called peritoneum, which allows waste products and extra fluid to pass from the blood into the dialysate. The dialysate typically stays in your body for about four to five hours, before it is drained and replaced as part of the dialysis session.
Why does my diet matter?
Between dialysis sessions, toxic waste can build up in the bloodstream and make you sick. As such, healthy eating can help manage the side effects of dialysis sessions as well as the periods in between each session.
A proper diet catered to your dialysis schedule and diabetes condition is thus vital to helping you feel better and reduce the amount of waste products in the blood and replenish some of the nutrients you might lack.
If you are on peritoneal dialysis, the dietitian will also take into account the quantity of dialysate solution you’re using. This is because the dialysate is usually a sugar-based solution and the use of it can affect your blood sugar levels.
Keeping a close watch on your diet may also prevent certain minerals from building up in your bloodstream. For people on dialysis, the kidneys can no longer remove high levels of minerals such as potassium and phosphorus.
Extra potassium in the bloodstream can lead to irregular heartbeat, weakness and shortness of breath, while high levels of phosphate can attract calcium from the bones, making them weak and brittle, among other side effects.
You should also consume more protein to replace the protein you lose during dialysis treatments, as well as to build muscle and lower your risk for infection.
On top of that, you need to make sure you are getting enough calories every day because they are important to keep your energy levels up.
Why do I need to watch what I drink?
Besides keeping a careful watch on the food that you eat, you should also take into account the amount of fluids you drink. Fluids can build up quickly between dialysis treatments and cause bloating and discomfort. The right amount of fluid intake can help you feel your best.
Dialysis filters the blood to remove excess fluid but it cannot do the job as effectively as healthy kidneys which work around the clock. Most people on dialysis, however, make little to no urine, because their kidneys can no longer remove wastes and extra fluid from the body effectively. Without urination, fluid builds up in the body and can cause swelling, shortness of breath and weight gain.
What is albumin and why is it important?
Albumin is a type of protein and is normally found in the blood after it's been filtered out by the kidneys. When your kidneys are healthy, there should be a minimal amount of albumin detected in your urine5.
Unusual amounts of albumin in your urine is a sign of kidney damage and is typically caused by diabetes. As such, your albumin level should be tested regularly through a urine test, to prevent serious kidney damage. With the right level of albumin, you also lower your risk of complications like infections or hospitalisation.
Consult your doctor to find out what your target albumin level should be and talk to your dietitian about nutritional options to help you reach that target.
1National Kidney Foundation. Retrieved on Sept 9, 2015 from: https://www.kidney.org/atoz/content/diabetes.
2WebMD. Retrieved on Sept 9, 2015 from: http://www.webmd.com/a-to-z-guides/uremia-topic-overview.
3Mayo Clinic. Retrieved on Sept 9, 2015 from: http://www.mayoclinic.org/tests-procedures/hemodialysis/basics/definition/prc-20015015.
4Mayo Clinic. Retrieved on Sept 9, 2015 from: http://www.mayoclinic.org/tests-procedures/peritoneal-dialysis/basics/definition/prc-20013164.
5WebMD. Retrieved on Sept 9, 2015 from: http://www.webmd.com/diabetes/microalbumin-urine-test.