Symptoms related to kidney failure usually occur only in late stages of the disease, when kidney function has diminished to less than 25 percent of normal capacity. For many years before that point, kidney disease of diabetes exists as a silent process. The kidneys produce erythropoietin, a hormone that stimulates the body to make red blood cells. Persons with ESRD have anemia because the body does not enough red blood cells. Symptoms include decreased energy levels, motivation and exercise tolerance.
Treatment consists of periodic erythropoietin injections or kidney transplantation.
Five Stages Scientists have described five stages in the progression to ESRD in people with diabetes. The rate of filtration remains elevated or at near-normal levels, and the glomeruli begin to show damage. In its earliest stages, microalbuminuria may come and go. But as the rate of albumin loss increases from 20 to 200 micrograms per minute, microalbuminuria becomes more constant. A special test is required to detect microalbuminuria.