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Kidney Disease: Often a Silent Killer

Terri Ackerman

Last updated: November 9, 2016 8:38 pm

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Many Americans live with diabetes or pre-diabetes. According to a recent study, roughly 50 percent of “all U.S. adults have diabetes or blood sugar so high they’re almost diabetic…” This news is significant because diabetes kills more than 70,000 people each year. 1

In addition, approximately 29 million Americans are living with diabetes, and 86 million are living with pre-diabetes. 2

Trends in Kidney Disease Mixed

A report released by the U.S. Renal Data System “reveals both positive and negative trends in kidney disease.” Although in recent years kidney dialysis and kidney transplants have extended the lives of individuals suffering from kidney damage, “the prevalence of end-stage kidney disease … [has] continued to rise.” 3

Chronic Kidney Damage Linked to Diabetes and High Blood Pressure

Our kidneys perform a vital function, filtering excess fluid and waste products out of our blood through urine. Our kidneys also play a role in controlling blood pressure. 4

Chronic kidney disease typically happens gradually. Because the damage generally occurs slowly and its effects in early stages are subtle, you may not notice any particularly troubling signs or symptoms at first. 5

Over time, however, chronic kidney disease can allow waste products to accumulate in your body and damage other organs.

CKD, Diabetes and UTIs

Diabetes has been linked to serious urinary tract infections (UTIs). 6 The U.S. Food and Drug Administration (FDA) has warned consumers that certain medications, known as SGLT2 inhibitors, are used to treat type 2 diabetes, along with diet and exercise. These SGLT2 inhibitors include drugs such as Invokana and Farxiga, and have been linked with serious blood infections (urosepsis) and kidney infections (pyelonephritis) that began as urinary tract infections. 7

Acute Kidney Injury Happens Suddenly

Acute kidney injury refers to “a sudden change in kidney function” that happens over hours or days. This condition may occur as a result of injury, illness or certain medications. 8

The FDA has identified a signal of potential serious risk of acute kidney injury in patients taking the diabetes medicines known as SGLT2 inhibitors. 9 In addition, Health Canada, the Canadian equivalent of the FDA, identified “a link between events of acute kidney injury” and the use of SGLT2 inhibitors. Health Canada was working with diabetes medication manufacturers to update Canadian prescribing information to “strengthen the wording relating to kidney injury to reflect this risk.” 10

Kidney Failure Death

Whether you have chronic kidney disease or experience acute kidney injury, if your kidneys stop working, the result can be life-threatening. Treatment to prevent kidney failure death is essential. 11

For kidneys that have failed, treatment options are kidney dialysis or a kidney transplant. If kidneys are not damaged irreparably, but their function has been diminished, your doctor may recommend modifying your diet and daily activities. 12

FDA Issues Warnings for Diabetes Medications SGLT2 Inhibitors

FDA has issued safety advisories regarding the SGLT2 inhibitors, noting “canagliflozin, dapagliflozin, and empagliflozin may lead to ketoacidosis, a serious condition where the body produces high levels of blood acids called ketones that may require hospitalization.” 13

The FDA advises people to seek medical attention immediately if they experience symptoms of diabetic ketoacidosis “such as difficulty breathing, nausea, vomiting, abdominal pain, confusion, and unusual fatigue or sleepiness.” 14 Diabetic ketoacidosis (DKA) is “a serious condition that can lead to diabetic coma … or even death.” 15

The FDA has revised the labels for all of the SGLT2 inhibitors to include warnings regarding the risks of DKA and serious urinary tract infections. 16

Get more information about SGLT2 inhibitors and the risk of diabetic ketoacidosis.

  1. http://www.nbcnews.com/health/diabetes/half-americans-have-diabetes-or-high-blood-sugar-survey-finds-n423491 

  2. http://www.prnewswire.com/news-releases/report-identifies-positive-news-on-kidney-disease-in-the-us-yet-challenges-remain-300205313.html

  3. https://www.sciencedaily.com/releases/2016/01/160118084155.htm 

  4. http://www.niddk.nih.gov/health-information/health-communication-programs/nkdep/learn/causes-kidney-disease/kidney-disease-basics/Pages/kidney-disease-basics.aspx  

  5. http://www.niddk.nih.gov/health-information/health-communication-programs/nkdep/learn/causes-kidney-disease/kidney-disease-basics/Pages/kidney-disease-basics.aspx 

  6. http://www.fda.gov/Drugs/DrugSafety/ucm475463.htm  

  7. http://www.fda.gov/Drugs/DrugSafety/ucm475463.htm 

  8. http://www.niddk.nih.gov/health-information/health-communication-programs/nkdep/learn/causes-kidney-disease/kidney-disease-basics/Pages/kidney-disease-basics.aspx; http://www.mayoclinic.org/diseases-conditions/kidney-failure/basics/definition/con-20024029 

  9. http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/ucm491645.htm 

  10. http://www.hc-sc.gc.ca/dhp-mps/medeff/reviews-examens/sglt2-eng.php 

  11. https://www.nlm.nih.gov/medlineplus/kidneyfailure.html  

  12. https://www.nlm.nih.gov/medlineplus/kidneyfailure.html 

  13. http://www.fda.gov/Drugs/DrugSafety/ucm446845.htm  

  14. http://www.fda.gov/Drugs/DrugSafety/ucm446845.htm  

  15. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html 

  16. http://www.fda.gov/Drugs/DrugSafety/ucm475463.htm