Diabetes is the leading risk factor for kidney disease and the number one cause of kidney failure. More than 29 million Americans have diabetes, and almost half of all kidney failure cases are caused by diabetes. Diabetes is a disease that causes your body to have trouble making or using insulin. Insulin is a hormone (a chemical your body makes) that helps your body turn the sugar you eat (also called glucose) into energy. When your body doesn’t use insulin the way it should, too much sugar stays in your blood.Your kidneys are full of tiny blood vessels (glomeruli) that help to clean your blood. Too much sugar in your blood can hurt these blood vessels. When your kidneys are damaged by having high blood sugar, you have diabetic kidney disease (also called diabetic nephropathy).