Diabetes and Kidney Disease (cont.)

Dialysis and Transplantation

When people with diabetes experience kidney failure, they must undergo either dialysis or a kidney transplant. As recently as the 1970s, medical experts commonly excluded people with diabetes from dialysis and transplantation, in part because the experts felt damage caused by diabetes would offset benefits of the treatments. Today, because of better control of diabetes and improved rates of survival following treatment, doctors do not hesitate to offer dialysis and kidney transplantation to people with diabetes.

Currently, the survival of kidneys transplanted into people with diabetes is about the same as the survival of transplants in people without diabetes. Dialysis for people with diabetes also works well in the short run. Even so, people with diabetes who receive transplants or dialysis experience higher morbidity and mortality because of coexisting complications of diabetes—such as damage to the heart, eyes, and nerves.

Good Care Makes a Difference

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People with diabetes should

  • have their health care provider measure their A1C level at least twice a year. The test provides a weighted average of their blood glucose level for the previous 3 months. They should aim to keep it at less than 7 percent.
  • work with their health care provider regarding insulin injections, medicines, meal planning, physical activity, and blood glucose monitoring.
  • have their blood pressure checked several times a year. If blood pressure is high, they should follow their health care provider's plan for keeping it near normal levels. They should aim to keep it at less than 130/80.
  • ask their health care provider whether they might benefit from taking an ACE inhibitor or ARB.
  • ask their health care provider to measure their eGFR at least once a year to learn how well their kidneys are working.
  • ask their health care provider to measure the amount of protein in their urine at least once a year to check for kidney damage.
  • ask their health care provider whether they should reduce the amount of protein in their diet and ask for areferral to see a registered dietitian to help with meal planning.
Medically Reviewed by a Doctor on 4/4/2014

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Diabetes and Kidney Disease - Symptoms Question: What kinds of symptoms did you experience with kidney disease?
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Diabetes and Kidney Disease - Care Question: In what ways do you maintain your health as a patient with diabetes and kidney disease?

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