For your loved one with diabetes, encourage them to get their kidneys checked regularly. Their provider will do this with blood and urine tests. Regular testing is their best chance for early identification and treatment of kidney disease, which is most effective in helping to prevent additional health problems.
Not everyone with diabetes will develop kidney disease, but with one-third of this population having it, it's important to take every precaution possible.
How diabetes causes kidney disease
Each kidney is made up of millions of nephrons. Nephrons are tiny filters that move waste and excess fluid from the blood and put it into urine to exit the body. Over time, high blood sugar from diabetes can damage the microvessels that supply blood to the nephrons and they stop working as well as they should. Many people with diabetes also develop high blood pressure, further contributing to kidney damage.
Damaged kidneys cannot adequately remove waste products and excess fluid from the body. Fluid volume and toxins remaining in the bloodstream start to build up, causing health problems. In addition to filtering and fluid volume control, the kidneys also help with maintaining blood pressure, keeping bones healthy, and assisting with red blood cell production.
Should damage progress to kidney failure (end-stage renal disease or ESRD), it could be life-threatening.
Kidneys work hard adjusting and compensating until they can't anymore, so chronic kidney disease (CKD) takes a long time to develop and usually doesn’t have any signs or symptoms in the early stages (1 and 2), possibly even into later stages (3 and early 4). Your loved one won't know they have CKD without a provider's evaluation.
What is diabetic nephropathy?
Just another name for kidney disease that is caused by diabetes. Kidney disease caused by diabetes is also called diabetic kidney disease (DKD). You'll hear these used interchangeably with CKD when the cause of CKD is diabetes.
Nephropathy broken down is 'nephro-' = kidney and '-pathy' = disorder.
Tips to keep kidneys healthy in diabetes
#1 - stay as close as possible to target blood sugar levels
#2 - maintain healthy blood pressure
Stay in the target cholesterol range
Eat foods lower in sodium
Eat more fruits and vegetables
Be physically active and maintain a healthy weight
Take all medicines as directed
The ACE-Inhibitor and ARB drug classes are especially good at protecting kidney function
Avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen
Beware of herbal supplements (check with a provider)
Promptly report any difficulty with urination to a provider
Factors that increase kidney disease risk in diabetes (and overall)
SMOKING - #1
Excessive alcohol intake or substance use
Obesity, or even excess belly fat if not obese
Not adhering to medication regimen
Family history of heart disease
Sedentary (no activity) lifestyle
A poor diet loaded with bad fats, cholesterol, and lots of sodium (salt)
Increased stress
Kidney failure
Once kidneys fail, dialysis or transplant is necessary. Your loved one must choose whether to continue with dialysis or get a kidney transplant.
For transplant, unless a family member is a match and willing to donate a kidney immediately, your loved one will apply to get on the national registry for a kidney transplant and be placed on a waitlist until a match is available (through organ donation).
