Preventing Chronic Kidney Disease When You Have Diabetes

According to The Cleveland Clinic Foundation, diabetes is the cause of approximately 44% of all new cases of diabetic nephropathy. Nephropathy is a medical term for kidney disease. Diabetes can cause damage to the filters in your kidneys over time. As more damage occurs, chronic kidney disease (CKD) can develop. CKD is a serious complication of diabetes. It cannot be cured, only managed. Getting an early diagnosis of nephropathy and treating your diabetes can help limit the kidney damage and may prevent kidney failure where dialysis becomes necessary.

An early diagnosis

An early diagnosis of diabetes can help your doctor treat the condition before it does more damage to your body. Type 1 diabetes (also known as juvenile or insulin dependent diabetes) is easily diagnosed in its early stages, before kidney damage occurs. However, Type 2 diabetes (also known as adult-onset or non-insulin dependent diabetes) often goes undiagnosed for years. Many people who have Type 2 diabetes do not realize it.  

Because Type 2 diabetes may have been present for many years before it is diagnosed, this means the high glucose (sugar) content in the blood has had time to damage the tiny blood vessels in the kidneys. When these blood vessels are damaged, protein that is meant to remain in the body can leak into the urine. This is a condition called microalbuminuria, and it is an early symptom of kidney disease.

If you have been diagnosed with Type 1 or Type 2 diabetes, you should have a microalbumin test done annually. This will help your doctor detect any kidney damage. If your urine tests positive for albumin (a protein), steps can be taken to help prevent more damage to your kidneys.

Control your blood glucose levels

Because the high glucose content in your bloodstream can damage the kidneys, controlling the level of glucose is an important step in keeping the kidneys healthy. This means following the plan your doctor recommends for treating your diabetes. For Type 1 diabetics, getting regular insulin is crucial in keeping glucose levels in check. For Type 2 diabetics, diet and exercise may be the primary treatments for lowering blood sugar levels.

Your doctor may have you test your glucose levels throughout the day. You may be referred to a dietitian, who can help you make healthier food choices. Lowering your intake of sugar is important, especially if you are insulin resistant. Your doctor may also want you to lose excess weight. Follow your doctor’s instructions regarding medicines and testing your glucose levels. If the levels are still too high, tell your doctor so adjustments can be made to your treatment program.

Control your blood pressure levels

If you are diabetic and have been diagnosed with high blood pressure (also known as hypertension), your kidneys have a greater chance of becoming damaged. Patients with high blood pressure and diabetes are more likely to develop nephropathy. This is because high blood pressure places added strain on the tiny blood vessels of the kidneys. Your doctor may prescribe a medicine called an ACE inhibitor to bring down your blood pressure.

Even in diabetic patients who do not have high blood pressure, studies have shown that ACE inhibitors are an effective treatment for kidney disease. Even though you may not have high blood pressure, your doctor may prescribe this medicine for you in order to prevent further strain to your kidneys. If you have any questions or concerns about any medicine that has been prescribed to you, talk with your doctor. Do not stop taking any medicine prescribed to you without talking to your doctor first.

Keep healthy habits

If you have been diagnosed with diabetes, your doctor may ask that you stop certain activities that could worsen your diabetes or lead to high blood pressure. Activities such as smoking and drinking alcohol should be avoided.

Exercise is an excellent habit. Your doctor may recommend exercise as part of your treatment. But before you start a program, ask your doctor if the activity may be right for you. 

Summary

Diabetes does not necessarily have to lead to chronic kidney disease. An early diagnosis of kidney disease may help you and your health care team to prevent further damage. Keeping your diabetes in check may help keep your kidneys healthy for a long time.

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a kidney doctor tool to locate a nephrologist in your area.

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