The Link Between Diabetes and Kidney Disease

According to the CDC, chronic kidney disease (CKD) affects nearly 37 million Americans, which is about 15% of adults. Although there are treatments available, kidney diseases are still one of the leading causes of death in the US. While you can be diagnosed with CKD regardless of underlying conditions, individuals with diabetes mellitus are at a much higher risk. In fact, nearly 1 in 3 people with diabetes have kidney damage or CKD, which can progress to kidney failure if left untreated. To better understand their relationship, here's everything you need to know about the link between diabetes and kidney disease.

How Does Diabetes Affect Kidney Function

The kidneys work as filtration systems to maintain homeostasis within the body and remove waste products from the blood. Excess water and other waste are removed using a complex network of filtration units, and urine is formed.

High blood sugar levels can damage the blood vessels in these filtration units, which is common among individuals with type 1 diabetes and type 2 diabetes. When damage occurs, efficiency decreases, causing kidney strain. Over time, consistently elevated glucose levels can narrow and clog the blood vessels in the kidneys.

What is Chronic Kidney Disease?

Chronic kidney disease (CKD) is a medical term that's used when your kidneys have been damaged and can no longer function at their best. Although it's common in people with type 1 and type 2 diabetes, CKD can occur in anyone. However, diabetes-related kidney disease is commonly referred to as diabetic nephropathy, diabetic kidney disease (DKD), or kidney disease of diabetes in people with diabetes.

Pyeloplasty Benefits vs. Risks

Although minimally invasive, pyeloplasty is still a surgical procedure that carries unique risks. The most common risks include:

• Infection
• Scarring
• Excessive bleeding
• Blood clots
• Hernias
• Bad reactions to anesthesia
• Damage to blood vessels
• Damage to nearby organs
• Need for additional surgery
• Urine leakage

Still, pyeloplasty is a surgical treatment to relieve pain and prevent kidney failure, so it's often considered necessary. Some of the advantages of pyeloplasty include pain relief, reduced swelling in the kidney and ureter, and improved overall function.

How to Prepare for a Pyeloplasty

Your doctor will give you instructions to help you prepare for a pyeloplasty. Typically speaking, this includes following a few directions. Most commonly, your doctor will ask you to:

• Fast (no food or water) for eight to twelve hours before the procedures
• Discontinue unnecessary medication on the day of the operation, or only take them with a small sip of water (do not stop taking any medications unless explicitly told to do so by your doctor)
• Prepare to stay in the hospital following the surgical procedure
• Ask a friend or family member to drive you home

How Can Pyeloplasty Surgery Be Performed?

Pyeloplasty is generally considered a minimally invasive procedure, but there are several options for individuals who need treatment. Most surgeries take about two to three hours, and you may be required to stay in the hospital for a few days after surgery. The different surgical options include:

Laparoscopic Pyeloplasty

During laparoscopic surgery, small incisions are made in the abdomen, through which a thin tube with a camera and specialized instruments are inserted. The surgeon then accesses the UPJ and removes the obstructed portion of the ureter before reconstructing it to allow for proper urine flow.

Endoscopic Surgery

In this procedure, a thin, flexible instrument called an endoscope is inserted through the urinary tract, typically via the urethra, to access the UPJ. The surgeon can visualize and navigate the obstruction using advanced surgical tools passed through the endoscope, often without external incisions. Normal urine flow is restored after removing the obstructed segment and reconstructing the ureteropelvic junction.