According to the CDC, chronic kidney disease (CKD) affects nearly 37 million Americans, which is about 15% of adults. Although there are treatments available, kidney diseases are still one of the leading causes of death in the US. While you can be diagnosed with CKD regardless of underlying conditions, individuals with diabetes mellitus are at a much higher risk. In fact, nearly 1 in 3 people with diabetes have kidney damage or CKD, which can progress to kidney failure if left untreated. To better understand their relationship, here's everything you need to know about the link between diabetes and kidney disease.
How Does Diabetes Affect Kidney Function
The kidneys work as filtration systems to maintain homeostasis within the body and remove waste products from the blood. Excess water and other waste are removed using a complex network of filtration units, and urine is formed.
High blood sugar levels can damage the blood vessels in these filtration units, which is common among individuals with type 1 diabetes and type 2 diabetes. When damage occurs, efficiency decreases, causing kidney strain. Over time, consistently elevated glucose levels can narrow and clog the blood vessels in the kidneys.
Diabetes can also damage the nerves within your body, resulting in diabetic neuropathy. This makes it difficult for your brain and body to communicate, especially regarding the bladder. You may not realize your bladder is full, which can put even more pressure on your kidneys.
People with diabetes also tend to have high blood pressure, which can further damage the blood vessels within the kidneys. When neither is properly managed, damage continues to occur. Over the years, even slow kidney damage can cause kidney disease, so early treatment is essential.
What is Chronic Kidney Disease?
Chronic kidney disease (CKD) is a medical term that's used when your kidneys have been damaged and can no longer function at their best. Although it's common in people with type 1 and type 2 diabetes, CKD can occur in anyone. However, diabetes-related kidney disease is commonly referred to as diabetic nephropathy, diabetic kidney disease (DKD), or kidney disease of diabetes in people with diabetes.
Unfortunately, once your kidneys have been damaged, there's no cure. However, treatment options can help with symptoms and prevent the damage from worsening.
The disease progresses through five different stages. The final stage of kidney disease is end-stage renal disease (ESRD). If you reach ESRD, you'll either need chronic renal dialysis or a kidney transplant.
Risk Factors for Developing CKD
One of the biggest risk factors that can lead to kidney disease is diabetes. People with type 1 diabetes are at the highest risk, as it's usually diagnosed earlier in life, causing an increased risk of complications. People with type 2 diabetes are also at risk, especially if they're undiagnosed or not properly managing the condition.
Other risk factors include:
- Family history of kidney disease
- Smoking
- High blood pressure (hypertension)
- High blood sugar (hyperglycemia)
- High blood cholesterol
- Obesity
Symptoms of Kidney Disease
Unfortunately, the early stages of diabetic nephropathy or kidney disease aren't always noticeable. Many of the symptoms don't appear until the progression of kidney disease. At this time, you may experience one or more of the following:
- Loss of appetite
- Foamy urine
- Proteinuria
- Swelling of feet and ankles
- Swelling of hands
- Swelling of eyes
- Itchiness
- Shortness of breath
- Confusion
- Difficulty thinking
- Nausea
- Vomiting
- General tiredness
- Weakness
- High blood pressure that's difficult to control
If you experience any of these symptoms, it's important to see your doctor as soon as possible. Being proactive about the complications of diabetes and seeing your doctor for regular checkups are also important, so try to maintain regular appointments that can help increase the likelihood of early detection.
Complications of Diabetic Nephropathy
When early kidney damage is left untreated and uncontrolled, it can result in some serious complications. Some of the most notable include:
- Cardiovascular disease
- Anemia
- Pulmonary edema
- Hyperkalemia
- Complications during pregnancy
- Kidney failure
Ways to Protect Your Kidneys When Living with Diabetes
Although diabetes and chronic kidney disease are often intertwined, there are several things that you can do to help protect your kidney health and slow the progression of diabetic nephropathy.
Make Healthy Lifestyle Changes
Healthy lifestyle habits make it easier to control both your blood sugar and your blood pressure, thus reducing your risk of complications like kidney damage. Some of the most important changes to make include:
- Smoking cessation
- Following a diabetes meal plan
- Reducing salt and sodium intake
- Becoming more active
- Achieving a healthy weight
- Adopting a healthy sleep schedule
Limit Protein Intake
Although there are several benefits to a high-protein diet, it's not recommended for people with diabetes and kidney problems. Protein is filtered in the kidneys, and an excessive amount can put unnecessary strain on your body. While you shouldn't cut it out completely, there's no reason to eat like a bodybuilder. The best way to ensure your diet is helping to slow the loss of kidney function while supporting your diabetes is to work with a nutritionist specializing in both.
Manage Blood Sugar Levels
Many people with diabetes follow a management plan that helps keep blood sugar stabilized. However, some things can cause spikes or dips. To help reduce the excess strain on your kidneys, it's important to take a proactive approach to blood sugar, from diabetes medications to lifestyle habits. If you're having difficulty keeping up with your management plan, talk to your doctor about alternative options or different medications. Managing diabetes can prevent or delay further kidney damage, so it's an essential protective measure to take.
Get Your Blood Pressure Under Control
High blood pressure and kidney disease also go hand-in-hand, so it's important to do what you can to get it under control. Work with your doctor to develop achievable targets and adopt a plan combining lifestyle changes and medication to help lower your blood pressure.
Take Your Medicine as Prescribed
Any medication that's prescribed to you should be taken as directed. This is one of the most important aspects of managing any underlying condition, especially regarding diabetes or diabetes-related complications. If you're experiencing unpleasant side effects, mention them to your doctor. Several medications achieve similar results, so you may respond better with something else.
If you're not already taking them, talk to your doctor about ACE inhibitors or ARBs. These medications are usually prescribed for high blood pressure, but they may offer protection against a decline in kidney function in people with diabetes. Even if your blood pressure levels are in a healthy, normal range, ACE inhibitors or ARBs may have additional benefits.
Finally, avoid any over-the-counter medications that may damage the kidneys. This is especially important regarding non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. Herbal supplements may also be problematic, so always check with your doctor before taking something new.
Try to Manage Stress Levels
Stress impacts metabolic activity, as it triggers the fight or flight response. This, in turn, can lead to elevated blood glucose levels that exacerbate issues. Although it can be difficult when trying to manage underlying conditions, eat right, get plenty of exercise, work, and balance a social life or family, and do what you can to incorporate stress-relieving activities throughout your day. Start meditating for five minutes every morning, end your day with a relaxing bath, and incorporate deep breathing exercises you can use when you're feeling particularly overwhelmed.
Long-Term Prognosis of Diabetic Kidney Disease
Kidney damage caused by diabetes can be serious, so it's important to work with your doctor to determine the best course of action. In the early stages, you will likely be prescribed a range of medications in addition to lifestyle changes and diabetes management plans. Medications often help control blood pressure, blood sugar, and cholesterol and reduce the risk of kidney scarring. In later stages, you may need to undergo regular dialysis or kidney transplantation.
Being diagnosed with chronic kidney disease can be scary, but there are things you can do to help slow its progression. The sooner it’s caught, the sooner you can act, so it’s important to see your doctor regularly—especially when living with diabetes. To help you manage your diabetes and reduce your risk of complications, Byram Healthcare has a range of diabetes supplies. We also offer diabetes educational materials and other resources to help you stay healthy and reduce your risk of complications.
