Manage your diabetes and blood pressure well to lower the chance of developing chronic kidney disease.
Kidneys—what would we do without them? Loaded with millions of tiny blood vessels that act as filters to remove waste from our blood, kidneys are remarkable organs.
But unfortunately, this filtering system sometimes breaks down. Failing kidneys lose their ability to filter out waste products, resulting in kidney disease.
Having diabetes puts your kidney health at risk. Prioritize your kidneys by visiting our interactive online experience to learn how to prevent or delay complications.
When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.
Diabetes can damage this system. High levels of blood glucose (blood sugar) make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria.
When kidney disease is diagnosed early, during microalbuminuria, several treatments may keep kidney disease from getting worse. Having larger amounts of protein in the urine is called macroalbuminuria. When kidney disease is caught later during macroalbuminuria, end-stage renal disease (ESRD) usually follows.
In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, ESRD, is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine (dialysis).
Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood glucose management, and blood pressure.
The better a person keeps diabetes and blood pressure well-managed, the lower their chance of getting kidney disease.
The kidneys work hard to make up for the failing capillaries, so kidney disease produces no symptoms until almost all function is gone. Also, the symptoms of kidney disease are not specific. The first symptom of kidney disease is often fluid buildup. Other symptoms of kidney disease include loss of sleep, poor appetite, upset stomach, weakness, and difficulty concentrating.
It is vital to see a doctor regularly. The doctor can check blood pressure, urine (for protein), blood (for waste products), and organs for other complications of diabetes.
Diabetes-related kidney disease can be prevented by keeping blood glucose in your target range. Research has shown that tight blood glucose management reduces the risk of microalbuminuria by one third. In people who already had microalbuminuria, the risk of progressing to macroalbuminuria was cut in half. Other studies have suggested that tight management can reverse microalbuminuria.
Important treatments for kidney disease are management of blood glucose and blood pressure. Blood pressure has a dramatic effect on the rate at which the disease progresses. Even a mild rise in blood pressure can quickly make kidney disease worsen. Four ways to lower your blood pressure are:
In addition to these steps and your diabetes medication, certain medications lower blood pressure. There are several kinds of blood pressure drugs. Work with your health care team about other medications that may be helpful for you to lower your risk of kidney disease.
You can plan a kidney-friendly meal by eating a balanced diet with a variety of whole, minimally processed foods and by following these general meal planning tips:
Talk to your health care provider about limiting fluid intake and to your registered dietician nutritionist (RDN) about other nutrition considerations. You may need to limit certain nutrients like sodium, potassium, and phosphorus in your eating plan. Your nutrition care plan might change over time depending on the status of your condition. Your RDN or health care provider will tell you if changes are needed based on your blood test results.
Once kidneys fail, dialysis is necessary. The person must choose whether to continue with dialysis or to get a kidney transplant. This choice should be made as a team effort. The team should include your doctor, diabetes educator, RDN, a nephrologist (kidney doctor), a kidney transplant surgeon, a social worker, and a psychologist.
If you or someone in your family has diabetes, high blood pressure, or a history of kidney disease, you could be at risk for serious complications.
Diabetes is a common condition and is the leading cause of kidney failure in the United States.
There are many ways to help delay kidney failure, especially when chronic kidney disease is diagnosed in the earlier stages.
A kidney transplant is the best possible treatment option for patients with kidney failure. If you aren't eligible for a kidney transplant, other options are available.
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