Learning About Kidney Disease and Diabetes

What is kidney disease and diabetes?

When you have diabetes, your body cannot make enough insulin or use it the way it should.

Your body needs insulin to help sugar move from the blood to the cells. Without it, your blood sugar gets too high.

High blood sugar damages your kidneys. It makes it hard for your kidneys to filter blood. This causes fluid and waste to build up in your blood.

If you have diabetes, it is very important to keep your blood sugar in your target range. There are many steps you can take to do this. If you can keep your blood sugar in your target range, you will have the best chance to slow or stop damage to your kidneys.

What are the symptoms?

There are no symptoms in the early stages. So it's important to have regular urine tests to find kidney damage early. As your kidneys are less able to do their job, you may have swelling in your body, often in your feet and legs. Other symptoms may include poor appetite, weight loss, and weakness.

How is it diagnosed?

Diabetic kidney disease is diagnosed using tests that check how well your kidneys are working. These include a test that checks for a protein called albumin in the urine. Another test checks how well your kidneys are filtering waste from your blood. This is called the estimated glomerular filtration rate (eGFR).

How can you care for yourself at home?

To manage your diabetes and slow or stop damage to your kidneys

• Keep your blood sugar in your target range. The American Diabetes Association recommends a hemoglobin A1c (Hb A1c) target level of less than 7%. Talk to your doctor about your target. The lower your A1c, the better your chance of stopping kidney damage.
• Keep your blood pressure in your target range. Doctors recommend certain types of blood pressure medicines for people who have diabetes and kidney disease. Examples include ACE inhibitors and angiotensin II receptor blockers (ARBs). Your doctor may have you take one of these even if you don't have high blood pressure.
• Take all of your medicines. You may have more than one. For example, you may take medicines for diabetes, cholesterol, and blood pressure. It's very important to take all of them just as your doctor tells you to and to keep taking them.
• Eat healthy foods. Follow an eating plan that is best for your diabetes and your kidneys. You may want to work with a dietitian to make a plan. This will help you know how much carbohydrate to have for meals and snacks. It will also make sure that you get the right amount of salt (sodium), fluids, and protein.
• Stay at a healthy weight. If you need help to lose weight, talk to your doctor or dietitian. Even small changes can make a difference. Try to be aware of your portion sizes. Eat more fruits and vegetables. And try to be active each day.
• Exercise. Get at least 30 minutes of activity on most days of the week. For many people, walking is a good choice. Being more active can help you manage your blood sugar and stay at a healthy weight. It also can help you lower your cholesterol and blood pressure.

To improve your kidney health

• Follow your treatment plan. Check your blood sugar as many times a day as your doctor recommends. Go to all of your follow-up appointments. Be sure to have all the tests your doctor orders. Call your doctor if you think you are having a problem with your medicines.
• Avoid certain medicines. Nonsteroidal anti-inflammatory drugs (NSAIDs) can damage your kidneys. Some examples of NSAIDs are ibuprofen and naproxen. It is important to talk to your doctor about all medicines that you take.
• Avoid smoking or using other tobacco products. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.