Great Gidayu Dies at 67 After Underestimating Diabetes—Doctors Warn of the Risk Factors That Can Lead to Dialysis

On September 7, Great Gidayu, who was beloved as a member of the “Takeshi-gundan,” passed away at the age of 67.

During his lifetime, Gidayu revealed that he suffered from diabetes and was undergoing dialysis. In his book “Tounyou da yo, Okka-san!” (Gentosha), he chronicled his own experience battling the disease.

“I really took diabetes too lightly.”

That was how Gidayu once reflected on his illness.

The cause of his death has not been disclosed, and it is unclear whether there was any connection to his diabetes or kidney failure. However, Gidayu’s words, after spending many years speaking publicly about diabetes and dialysis, once again highlight the dangers of the disease.

Diabetes is not a disease that suddenly causes severe symptoms. “My blood sugar is a little high.” “My blood pressure is also a little high.” While carrying abnormalities commonly found on health checkups like these, people may continue working and living their lives as usual, all while their kidneys are quietly sustaining damage.

What determines whether someone with diabetes eventually requires dialysis or is able to protect their kidneys and maintain their health? We asked Tadatoshi Tomohiro, director of Noborito Clinic, who treats many patients with lifestyle-related diseases. (The following quotations are from Dr. Tomohiro.)

Feeling fine is what makes it so dangerous

“The frightening thing about diabetes is that there are almost no subjective symptoms in the early stages. Even when their blood sugar is high, many people can continue working, eating, and going about their daily lives normally. They think, ‘I feel fine, so I must be okay.’ But in the meantime, the damage caused by high blood sugar is gradually accumulating in the body.”

One of the most common complications of diabetes is diabetic nephropathy, in which kidney function gradually declines. The kidneys filter the blood and excrete waste products, excess water, and salt in the urine. The glomeruli, which filter the blood, are delicate structures made up of clusters of tiny capillaries.

“When high blood sugar continues, it puts a strain on the small blood vessels and glomeruli in the kidneys. Over time, a protein called albumin, which normally barely appears in urine, begins to leak into it. As the condition progresses further, kidney function itself begins to decline.

When the kidneys can no longer adequately process waste products and excess water in the body, treatments such as dialysis or a kidney transplant become necessary. However, even when kidney function begins to deteriorate, symptoms such as pain do not appear. In some cases, there may be no obvious symptoms until the condition has progressed considerably.”

“There’s no pain.” “I can still work.” “I still have an appetite.”

None of these things alone means that a person is in the clear. Diabetic nephropathy does not suddenly occur one day. It progresses gradually over a long period of time.

However, diabetes does not automatically mean that a person will need dialysis.

“Developing diabetes does not necessarily mean that you will eventually require dialysis. By managing not only blood sugar but also blood pressure, lipids, body weight, and other factors, and by regularly monitoring the condition of the kidneys, it is possible to prevent kidney function from deteriorating. What is dangerous is thinking, ‘I’m cured’ because your numbers have improved, then stopping medication on your own or discontinuing medical appointments.”

Dr. Tomohiro emphasizes that the stage much earlier than right before dialysis is far more important.

“Diabetes patients sometimes ask me, ‘At what point will I need dialysis?’ But what matters is not knowing a specific number that marks a danger zone. Your blood sugar is a little high. Your blood pressure is also a little high. Your kidney function has started to decline slightly. But you don’t feel unwell—in this stage, what you do is extremely important.”

Whether you ignore slightly abnormal findings can make all the difference 10 years from now

Many people leave a warning noted on a health check unattended if they have no symptoms. Dr. Tomohiro says that it is precisely the judgment of “It’s only slightly abnormal, so I’m probably fine” that people should be careful about.

“Your blood sugar is slightly high, or your blood pressure is slightly high. Even if you’re told that, it’s not as though you’ll suddenly feel sick the next day. So you end up thinking, ‘I’ll wait and see until next year’s health checkup.’

But if you keep doing that for five or 10 years, the strain on your kidneys also accumulates. Whether you leave it alone thinking, ‘I’m still okay,’ or take that opportunity to review your lifestyle and treatment—those accumulated decisions will affect your kidney function 10 or 20 years down the road.”

As kidney function declines, symptoms such as swelling, fatigue, loss of appetite, and shortness of breath caused by anemia may appear.

“There are cases where, by the time people come to the hospital because they have developed swelling or shortness of breath, their kidney function has already declined considerably. It’s not a matter of ‘I’ll go to the hospital if symptoms appear.’ It is important to detect changes through testing and begin treatment before symptoms appear.”

So, how can changes in the kidneys be detected?

Two things to check during a health examination are creatinine (Cr) and eGFR (estimated glomerular filtration rate). Creatinine is a waste product produced by muscle metabolism and is normally filtered by the kidneys and excreted in urine. eGFR is an indicator used to estimate how effectively the kidneys are able to filter the blood.

“Even if you think your creatinine is only slightly high, your eGFR may have fallen into the 40s or 50s. Generally, an eGFR below 60 that persists for three months or longer is one of the criteria used to diagnose chronic kidney disease (CKD). If an abnormality is pointed out during a health check, it is important not to leave it unattended simply because it’s only slightly abnormal.”

For people with diabetes, urinary protein is also important.

“With kidney damage caused by diabetes, urinary protein can begin to increase before eGFR declines significantly. So you cannot conclude that your kidneys are fine simply by looking at HbA1c, an indicator of blood sugar control, and thinking, ‘My blood sugar is stable.’ It is important to assess the condition of the kidneys using both blood tests and urine tests.”

There is an important point to understand about chronic kidney disease: Once kidney function has significantly declined, it is difficult to restore it to its original state. Dr. Tomohiro emphasizes that “This is extremely important when considering kidney disease.”

“Once the kidneys have chronically lost function, they are basically organs that are difficult to restore to their original state. If your eGFR has fallen to 50, you generally cannot expect it to return to 80 or 90 simply by improving your lifestyle. That is why, with kidney disease, it is extremely important not to think, ‘I can treat it once it gets worse,’ but rather, ‘I need to prevent it from getting any worse.’”

So what can be done to protect the kidney function that remains?

“I tell my patients, ‘Let’s take good care of the kidneys you have left and use them carefully for the rest of your life.’ Manage your blood sugar and blood pressure properly, avoid consuming too much salt, and maintain an appropriate weight. Have regular checkups so that any changes in kidney function can be detected early.

By taking measures while you still have sufficient kidney function, there is a possibility of slowing the rate of decline, delaying the point at which dialysis becomes necessary for as long as possible, or even preventing the need for dialysis altogether. The important thing in treating kidney disease is not to restore lost function, but to protect the kidney function you still have for as long as possible.”

In other words, while your kidneys are still functioning is precisely the crucial time when you can take action that may affect your future.

Three times a week, four hours each time–How does dialysis change your life?

When kidney function declines significantly and the body can no longer adequately eliminate waste products and excess fluid, dialysis may become necessary. Conventional hemodialysis is generally performed three times a week, for about four hours each session.

“Dialysis is an extremely important treatment that supports patients’ lives. However, it cannot be said that the burden it places on daily life is small. People who work may need to adjust their working hours, and they also have to manage their diet, fluid intake, and weight.”

Some people finish work, undergo dialysis at night, and continue this lifestyle for years, returning home late at night. When traveling or going on business trips, they also need to find a medical facility where they can receive dialysis at their destination and make arrangements in advance.

“Some patients tell me after starting dialysis, ‘I wish I had paid more attention to my blood sugar and blood pressure sooner,’ or ‘I wish I hadn’t ignored my health checkup.’ Some people do not realize how much their kidneys had been working for them every day until they actually require dialysis.”

These words also echo the regret Great Gidayu expressed during his lifetime: “I really took diabetes too lightly.”

So what should people do to protect their kidneys from diabetes? Dr. Tomohiro says “There is no need to do anything special.”

“First, do not stop treatment based on your own judgment. Beyond that, manage your blood sugar, blood pressure, lipids, and weight. Avoid consuming too much salt. Continue exercising within reasonable limits. And regularly check your eGFR, urinary protein, and other indicators.

Diabetes treatment has also advanced considerably, and today, medications are selected not only to lower blood sugar but also with consideration for protecting the kidneys and heart. By continuing treatment from an early stage, there are many things that can be done.”

For people in their 30s or 40s, it is difficult to imagine needing dialysis 10 or 20 years from now. Even more so when there is no pain or discomfort. But what you do during that nothing seems wrong period is what matters.

Dr. Tomohiro offers this final message:

“Rather than thinking, ‘I’m fine because I don’t have any symptoms yet,’ I want people to think, ‘Precisely because I don’t have symptoms yet, there are things I can do.’ Although it is difficult to restore kidney function once it has declined, there are things you can do to protect the kidney function you have now and prevent it from getting worse. If a health checkup reveals an abnormality, I hope people will use it as an opportunity to review their lifestyle and treatment for their future selves.”

“I’m still okay.”

The period when you can think that way is not a time to leave things unattended.

It is a time when you can still make a difference.

The regret Great Gidayu left behind during his lifetime: “I really took diabetes too lightly.”

Those words now carry particular weight for people who are thinking, “I’m still fine.”