What Is the Relationship Between Diabetes and Kidney Disease?

Diabetic nephropathy occurs when blood vessels and other cells in the kidneys are damaged due to diabetes.

Your kidneys contain millions of tiny blood vessel clusters called glomeruli that filter waste from your blood. Chronic high blood sugar levels damage these blood vessels and lead to diabetic nephropathy, kidney failure, and decreased kidney function.

Causes of diabetic nephropathy

• Among people with type I and II diabetes, diabetic nephropathy is the most common complication.
• Poorly controlled diabetes can damage the blood vessel clusters in your kidneys that filter waste from the blood. It may result in kidney damage or high blood pressure.
• Blood pressure can cause further kidney damage by increasing pressure on the kidney's delicate filtering system.

Managing diabetes is the most important step to protect yourself from kidney disease, heart disease, and stroke. Change your lifestyle and live a longer, healthier life.

The ABCs of diabetes

• Hemoglobin A1C levels. Measures your average blood glucose over the past three months. Aim to achieve a score below seven percent if possible.
• High blood pressure. Causes your heart and kidneys to work too hard. Take your prescribed blood pressure medications without fail. To maintain normal blood pressure, you must keep it below 130/80 mmHg.
• Cholesterol. Monitor low-density lipoprotein cholesterol (LDL) levels. LDL can build up and clog the arteries. Ideally, the target should be below 100 mg/dL. Try to raise your high-density lipoprotein levels to keep the arteries clear.

Other ways to prevent kidney disease with diabetes

• Take your medications as prescribed by your doctor
• Keep up with doctor visits
• Exercise
• Change your diet
• Lose excess weight
• Measure your blood sugar regularly (Prediabetes does not mean diabetes.)
• Ask your doctor which over-the-counter pain medications are safe for you and follow label instructions while taking them (If you take too many pain medications, it can damage your kidneys.)
• Smokers should stop smoking

Diabetic kidney disease and kidney disease share similar symptoms. Symptoms of diabetic kidney disease are unlikely to appear in the early stages. The first symptom could be fatigue or a lack of energy.

Diabetic kidney disease may cause the following signs:

• Poor appetite
• Nausea
• Weight loss
• Dry, itchy skin
• Muscle cramps
• Puffiness around the eyes
• Frequent urges to urinate
• Fluid retention causes swollen feet and ankles
• Difficulty thinking clearly

Diabetes and kidney disease must be managed according to your doctor's instructions. Generally, you should control your blood sugar by taking certain steps every day.

1. Measure and record blood sugar levels: Your blood glucose (blood sugar) can be tested at home with a portable electronic device. A blood sugar meter uses a small drop of blood. Alternatively, you can use a continuous glucose monitor.
2. Manage blood pressure: More than 80 percent of people with diabetes and chronic kidney disease have hypertension. Consult your doctor about a treatment plan to help you control your blood pressure. You can take steps, such as having a healthy diet, exercising regularly, managing stress, and quitting smoking.
3. Take your medications as recommended: Your doctor may prescribe different medications based on kidney function, the stage of kidney disease, and whether you have any other health conditions. For diabetes management, your doctor may prescribe specific drugs to maintain optimal blood sugar levels.
4. Make healthy food choices: Read nutrition labels to select healthier options, such as those with less sodium and sugar. Fiber-rich foods, such as whole grains, fruits, and vegetables, may lower blood sugar. Consult your doctor or dietitian to plan a kidney-friendly diet.

An individual with prediabetes is on their way to developing diabetes. Prediabetes refers to a condition in which blood glucose (sugar) levels are higher than normal but not high enough to be diagnosed as diabetes.

Diabetes is a serious condition that causes problems throughout the body. Prediabetes is not diabetes.

The kidney is one of the most damaged organs in people with diabetes.

A large study reported that more than one-third of people with prediabetes had two signs of kidney disease:

1. Proteinuria (protein in the urine). Normally, the urine should contain less than 150 mg (about three percent of a teaspoon) of protein a day. Proteinuria is defined as having more than 150 mg per day.
2. Reduced estimated glomerular filtration rate. Indicates how well the kidneys are and the stage of kidney disease.

Chronic kidney disease was just as advanced in people with diabetes as in prediabetes.

Prediabetes and diabetes are often associated with stage III or IV chronic kidney disease. Chronic kidney disease has five stages. In stage V or end-stage renal disease, dialysis or kidney transplantation are the only treatment options.

You are more likely to develop kidney disease if you have had uncontrolled diabetes or blood glucose levels for a long time.

Risk factors include

• High blood pressure
• Smoking
• Kidney disease in your family
• Heart disease
• Obesity
• Sedentary lifestyle
• Not eating well to manage your diabetes
• Too much sodium in the diet

When your kidneys show signs of damage, your doctor will develop a plan to slow the disease by first controlling your blood glucose and pressure levels.

Medications

• Kidney disease can be slowed by certain blood pressure medicines, such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.
• You can take medicines even if you do not have high blood pressure. A new class of diabetes drugs called sodium-glucose cotransporter-2 inhibitors, Glucagon-like peptide-1 agonists, and nonsteroidal mineralocorticoid receptor antagonists may help treat diabetic kidney disease.
• You will need to take any medications your doctor recommends for type II diabetes.

If your kidneys are under stress, your doctor may recommend limiting your protein consumption.

The kidneys function at 10 to 15 percent of their normal capacity when kidney disease leads to body functioning. A person with kidney failure needs dialysis or a kidney transplant. These treatment choices are also used for end-stage renal disease. However, most people with diabetic kidney disease do not end up with kidney failure.

Type II diabetes can be controlled by taking care of yourself and your health and following your doctor's recommendations.