Preventing or Delaying Kidney Disease
If you have diabetes, you're at risk for kidney disease, also called diabetic nephropathy. In fact, diabetes is the leading cause of kidney failure. But there are things you can do to prevent, delay, or treat kidney disease, including keeping blood glucose (sugar) and blood pressure on target.
What do my kidneys do?
Your kidneys clean your blood by constantly filtering it through millions of tiny blood vessels. They remove unwanted substances from your blood, such as extra fluid and the waste products made by normal processes within the body. Your kidneys perform other functions as well, such as helping to regulate blood pressure, stimulating your bone marrow to produce red blood cells, and helping your bones and your blood absorb calcium.
How can diabetes hurt my kidneys?
Frequent high blood glucose levels over the years can lead to changes in how the kidneys function. High blood glucose causes extra blood to flow through the filters, making the kidneys work harder than usual. Many people with diabetes have high blood pressure. High blood pressure in the kidneys' tiny blood vessels also puts added strain on the kidneys. High blood glucose and blood pressure levels can lead to scarring inside the filters so they don't work as they should.
Who gets kidney disease?
Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood glucose control, and blood pressure. The better a person keeps diabetes and blood pressure under control, the lower the chance of getting kidney disease.
| YOU CAN PREVENT OR DELAY KIDNEY DISEASE BY: | |
|---|---|
 | keeping your blood pressure and blood glucose levels in the target range |
 | having regular checkups and getting a kidney function check once a year |
 | taking medications for diabetes and high blood pressure as prescribed |
 | losing just 10 to 15 pounds, if you are overweight, which can help you reach your blood glucose and blood pressure targets |
| YOU CAN PREVENT OR DELAY KIDNEY DISEASE BY: | |
|---|---|
| | keeping your blood pressure and blood glucose levels in the target range |
| | having regular checkups and getting a kidney function check once a year |
| | taking medications for diabetes and high blood pressure as prescribed |
| | losing just 10 to 15 pounds, if you are overweight, which can help you reach your blood glucose and blood pressure targets |
How will I know if I have kidney problems?
Because kidney damage can occur for years without symptoms, the best way to Learn whether you have kidney problems is to have a sample of your urine checked once a year. This test, called a microaLbumin (MY-kro-aL-BYOO-min) test, can show whether your kidneys are leaking protein (also called albumin).
It's best to have this test when you're first diagnosed with type 2 diabetes and then once every year. Many people have protein in their urine when they're first diagnosed with type 2 diabetes or soon afterward because they may have had diabetes for years before it was detected. If diabetes is present, even if it hasn't been diagnosed, damage from high blood glucose levels can occur. If you have type 1 diabetes, you're unlikely to have kidney damage at diagnosis. But you'll need this test 5 years after diagnosis and every year after that.
How can I prevent or delay kidney disease?
Several things can help you prevent or delay kidney disease. If you already have kidney disease, these steps also help slow it down. All of these actions work best if you start them at the earliest stages of kidney disease:
Keeping your blood pressure on target helps you avoid kidney disease, heart and blood vessel problems, and diabetic eye disease. The American Diabetes Association recommends that most people aim for a blood pressure level of less than 140 over 90.
There are many types of medications to control blood pressure but one type in particular, called an ACE (angiotensin-converting enzyme) inhibitor, has been proven to slow the progression of kidney disease. In fact, it's so effective that doctors also prescribe it for people who don't have high blood pressure so that they can protect their kidneys. Another type of medication, called an ARB (angiotensin receptor blocker), also can help protect kidney function. You may need several types of blood pressure medications to reach your goaL.
Another important thing you can do is to reach your blood glucose targets as often as possible. Talk with your health care team about the best blood glucose targets for you.
This hand-out was published in Clinical Diabetes, VoL. 35, issue 4, 2017, and was adapted from the American Diabetes Association's Diabetes Advisor handouts “Diabetes and Kidney Disease” and “Preventing or Delaying Kidney Disease.” Visit the Association's Patient Education Library at http://professionaL.diabetes.org/PatientEd for hundreds of free, downloadable handouts in English and Spanish. Distribute these to your patients and share them with others on your health care team. Copyright American Diabetes Association, Inc., 2017.
