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Veterans Law

Kidney Disease and Type 2 Diabetes: Secondary Service Connection

March 24, 2019
Type 2 Diabetes and Kidney Disease

How Does Type 2 Diabetes Lead to Kidney Disease?

Diabetes is a disease in which your body does not make enough insulin, a hormone that regulates the amount of sugar in your body, or cannot use normal amounts of insulin properly.  As type 2 diabetes progresses, additional complications can develop, including kidney disease.  According to the National Kidney Foundation, type 2 diabetes is one of the leading causes of kidney disease.  Specifically, 10 to 40 percent of individuals with type 2 diabetes will eventually suffer from kidney failure.  Furthermore, people suffering from both diabetes and kidney disease have a worse prognosis than people with kidney disease alone.

Type 2 diabetes can cause damage to the kidneys and lead to kidney disease in a number of ways, including:

  • Damage to the blood vessels inside the kidneys. The kidneys are filled with tiny blood vessels.  Over time, high blood sugar levels in the blood can cause these vessels to become narrow and clogged.  As a result, the kidneys become damaged and albumin (a type of protein) passes through and ends up in the urine where it should not be.
  • Damage to the nerves in the kidneys. Diabetes can also cause damage to the nerves in your body, which carry messages between your brain and all other parts of your body, including your bladder.  If the nerves in your bladder are damaged, you may not be able to feel when your bladder is full.  The pressure from a full bladder can then damage your kidneys.
  • Urinary tract infection. Bacteria is prone to grow faster in urine with a high blood sugar level, causing infection that can spread to the kidneys

Diagnosis & Treatment

One of the earliest signs of kidney disease due to type 2 diabetes is increased excretion of albumin in an individual’s urine.  Other early warning signs include using the bathroom frequently throughout the night and having high blood pressure.  However, kidney disease due to diabetes often goes unnoticed until it has progressed.  Signs and symptoms that may occur in the later stages of the disease include:

  • Increased levels of blood urine nitrogen (BUN) and creatinine in your blood
  • Blood in urine
  • Swelling of the hands, feet, and face
  • Poor appetite and nausea
  • Weakness and fatigue

The treatment of kidney disease in diabetic patients is primarily focused on lowering blood pressure and maintaining blood sugar control to slow the progression of the disease.  If the kidney disease has progressed to the point of kidney failure, there are three main types of treatment: kidney transplant, hemodialysis, and peritoneal dialysis.

Secondary Service Connection for Kidney Disease Due to Type 2 Diabetes

A secondary service-connected disability is a disability that resulted from a condition that is already service connected.  For secondary service connection to be awarded, a nexus (i.e. a link) between the primary disability and secondary disability must be clearly established.  In this case, veterans must prove that their kidney disease is due to or the result of their already service-connected type 2 diabetes.  To apply for secondary service connection for kidney disease, veterans must file a claim and demonstrate the following to VA:

  • A current diagnosis of kidney disease
  • Medical evidence showing the relationship between his or her type 2 diabetes and his or her kidney disease

If secondary service connection is awarded, VA will then assign a disability rating for kidney disease.

VA Disability Ratings for Kidney Disease Due to Type 2 Diabetes

VA typically rates kidney disease under 38 CFR § 4.115a, Ratings of the Genitourinary System – dysfunctions, using the criteria for renal dysfunction.  The criteria for each disability rating are as follows:

  • 100% – requiring regular dialysis, or precluding more than sedentary activity from one of the following: persistent edema and albuminuria; or, BUN more than 80mg%; or, creatinine more than 8mg%; or, markedly decreased function of kidney or other organ systems; especially cardiovascular
  • 80% – persistent edema and albuminuria with BUN 40 to 80mg%; or, creatinine 4 to 8mg%; or, generalized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion
  • 60% – constant albuminuria with some edema; or, definite decrease in kidney function; or, hypertension at least 40% disabling under DC 7101
  • 30% – albumin constant or recurring with hyaline and granular casts or red blood cells; or, transient or slight edema or hypertension at least 10% disabling under DC 7101
  • 0% – albumin and casts with acute nephritis; or, hypertension non-compensable under DC 7101”

Call 800-544-9144 for a Free Case Evaluation with Chisholm Chisholm & Kilpatrick LTD

If you are seeking service connection for a secondary disability, the veterans lawyers at Chisholm Chisholm & Kilpatrick LTD may be able to help.  We offer a free case evaluation.  Call 800-544-9144 to speak with a member of our team today.