How Does Diabetes Contribute to Kidney Disease?

Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease.

Helpful Highlights

  • We cannot survive without our kidneys (or kidney function replacement therapy).

  • Diabetes can damage the kidneys and reduce their ability to filter waste products from the blood, among many other things.

  • Diabetes is the leading cause of kidney disease and end-stage renal (kidney) disease.

  • Managing blood sugar and blood pressure lowers the chance of kidney disease, or helps keep it from progressing.

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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)

  • Get connected with a diabetes educator

  • 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).


American Diabetes Association (ADA)


Johns Hopkins Medicine

Mayo Clinic

National Institute of Diabetes and Digestive and Kidney Diseases

National Kidney Foundation (NKF)

No content in this app, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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