Kidney Disease and Diabetes: Care Instructions

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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 and makes it hard for them 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 control your blood sugar, you will have the best chance to slow or stop damage to your kidneys.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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 specific 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 several. 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.
  • Make good food choices. 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 add some activity to your daily routine.
  • Exercise. Get at least 30 minutes of activity on most days of the week. Walking is a great exercise that most people can do. Being more active can help you manage your blood sugar and stay at a healthy weight. It also can help you lower 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, and 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), such as ibuprofen and naproxen, can damage your kidneys. It is important to talk to your doctor about all medicine that you take.
  • Avoid tobacco. Do not smoke or use 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.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • You have new or worse nausea and vomiting.
  • You have much less urine than normal, or you have no urine.
  • You are feeling confused or cannot think clearly.
  • You have new or more blood in your urine.
  • You have new swelling.
  • You are dizzy or lightheaded, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

Where can you learn more?

Go to

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.