Diabetes and Kidneys Complications

Diabetes causes vary on your genetic makeup, family history,  health, and environmental factors.

So,  you’ve heard that diabetes can cause problems with your kidneys. Let’s talk about that. Diabetes happens when the sugar levels in your blood are too high. 

Your kidneys sit just below your ribs, near your back. Their job is to filter your blood and get rid of waste products, and extra salt and water into your urine or pee.

Credit: Google images

When the sugar levels in your blood are too high for too long, this can cause damage to your body, for example, to your kidneys. 

If they become damaged, they can’t do that job properly. When kidney damage happens in someone living with diabetes, it sometimes goes by different names, like Diabetic kidney disease, Diabetic nephropathy, or more generally Chronic kidney disease, or CKD. 

Kidney damages

If Diabetic kidney disease damages the kidneys very badly, then the waste products and extra salt and water need to be removed another way, by either Dialysis or a Kidney transplant. 

Dialysis involves artificially filtering the blood several times a week, and a transplant involves receiving a new kidney from a donor. 

Dialysis is a treatment for people whose kidneys are failing. When the kidneys don’t filter blood the way they should. As a result, wastes and toxins build up in the bloodstream. 

Dialysis does the work of your kidneys, removing waste products and excess fluid from the blood.

Dialysis Treatment
Credit: Google images

Around four in 10 people living with diabetes may develop some signs of kidney disease in their lifetimes, but most people with diabetic kidney disease don’t end up with kidney failure that needs dialysis or a transplant. 

And the good news is, that if you take care of your diabetes, and even if you have kidney damage, then there are lots of things you can do to slow the loss of kidney function. 

We’ll talk about that a bit later. Kidney damage usually does ’cause any symptoms when it’s at its early stages, but the lab tests you do for your doctors are able to pick up early signs of kidney damage. 

This is called Screening. Usually, doctors will do two screening tests every year to check on your kidneys. 

One test is a urine test looking to see if proteins have leaked into your urine, a sign that the tiny filters in the kidneys are damaged. 

This test is often called an Albumin Creatinine ratio, or ACR, and a normal test result would be less than 2 milligrams per millimole. Albumin is a protein that is normally found in the blood, and ordinarily, the kidneys prevent most albumin from entering the urine.

The second test is a blood test to see how well your kidneys are filtering. The less they are filtering, the more damage they have had. 

This test is often called an eGFR. eGFR (estimated glomerular filtration rate) is a measure of how well your kidneys are working and eGFR is an estimated number based on a blood test and your body type, age, sex. 

However, the eGFR may not be accurate if you are pregnant,  younger than 18, very overweight, or very muscular. In addition, other tests such as a kidney biopsy or an ultrasound may be ordered to find the cause of your kidney disease.

An abnormal test result would be more than 90, but people usually don’t need medication changes unless the number is less than 60. 

If your tests show that you have early signs of kidney damage, your doctor may prescribe medications for you. 

These may include blood pressure medications, particularly pills called ACE inhibitors or ARBs; medications that help control your blood sugar, including medications called SGLT2 inhibitors in some people.

Cholesterol medications, called statins, help keep your heart healthy. And they may ask a dietitian to give you specialist advice. Here are some important tips to help keep you and your kidneys healthy. 

  • Most important is to keep your blood sugar under control, and to keep your blood pressure under control. 

  • Talk to your diabetes care team about your targets to control your blood sugar and blood pressure. 

  • Take your medications as prescribed, and keep your health-care appointments. 

  • Don’t smoke. Smoking damage blood vessels, which decreases the flow of blood circulation in the kidneys. When the kidneys don’t have adequate blood flow, they can’t function properly. Smoking also increases the risk of high blood pressure as well as the risk of kidney cancer.  

  • Regular Exercise. Maintain a healthy weight and stay physically active.
  • Reduce salt intake, Consuming too much salt can make it harder for your kidneys to remove fluid, which increases your blood pressure.

Follow the recommendations of your dietitian. Sometimes, if you get sick for another reason, then the medications that you take can actually become harmful. 

Talk to your health care team about a sick day plan. It’s normal to worry about your future health from time to time. 

By taking your medications, having your screening tests, making healthy choices, and working with your diabetes care team, know that you’re making the best investment possible for you to enjoy along with a healthy future. 

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