Diabetes and chronic kidney disease: What you need to know

Your kidneys, each just the size of a computer mouse, filter all the blood in your body every 30 minutes. They work hard to remove wastes, toxins, and excess fluid. They also help control blood pressure, stimulate production of red blood cells, keep your bones healthy, and regulate blood chemicals that are essential to life.

Kidneys that function properly are critical for maintaining good health. However, more than one in seven American adults are estimated to have chronic kidney disease (CKD).

CKD is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke.

Some other health consequences of CKD include:

• Anaemia or low number of red blood cells
• Increased occurrence of infections
• Low calcium levels, high potassium levels, and high phosphorus levels in the blood
• Loss of appetite or eating less
• Depression or lower quality of life

CKD has varying levels of seriousness. It usually gets worse over time although treatment has been shown to slow progression. If left untreated, CKD can progress to kidney failure and early cardiovascular disease. When kidney damage is severe and kidney function is very low, dialysis or kidney transplant is needed for survival. Kidney failure treated with dialysis or kidney transplant is called end-stage kidney disease.

Not all people with kidney disease progress to kidney failure. To help prevent CKD and lower the risk for kidney failure, it is important to control risk factors for CKD, get tested yearly, make lifestyle changes, take medicine as needed, and see your health care team regularly.

What are the risk factors?

• Diabetes
• High blood pressure
• Heart disease
• Family history of CKD
• Obesity

Yes, diabetes is one of the risk factors. But we have good news! Take note of the following kidney-friendly tips; they can make a difference in your life:

• Maintain your blood pressure below 140/90 mm Hg (or the target your doctor establishes for you).
• Stay in your target blood glucose range as much as possible.
• Get active—physical activity helps control blood pressure and blood glucose levels. 30 minutes of physical activity most days of the week should be your goal. It is easy – just walk.
• Lose weight if you’re overweight.
• Get tested for CKD regularly if you’re at risk.
• If you have CKD, meet with a dietician to create a kidney-healthy eating plan. The plan may need to change as you get older or if your health status changes.
• Take medications as prescribed by your doctor and ask them about blood pressure medicines called angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, which may protect your kidneys in addition to lowering blood pressure.
• If you smoke, quit. Smoking can worsen kidney disease and interfere with medication that lowers blood pressure.
• If you have type 2 diabetes, talk to your diabetes doctor about including in your treatment regimen one of the new class of diabetes medications called SGLT2 inhibitors *, which have now been shown to decrease the rate of progression of diabetic kidney disease.
• Include a kidney doctor (nephrologist) on your health care team as your kidney disease progresses. Ask your diabetes doctor to refer you to a kidney doctor when there is evidence of kidney disease progression.

Take Aways OR Pearls of Wisdom

• Early education can lead to prevention
• Manage diabetes to the best of your ability
• Maintain healthy blood pressure
• Team-based care is essential for complex diseases like diabetes, include a kidney doctor early in the game

You can learn more at the following links:

• Info Cards on Diabetes (English and Spanish)
• Prevent Complications (English and Spanish)
• Get Tested for Chronic Kidney Disease (only in English)
• Kidney Disease and Diabetes (only in English)
• Diabetic Kidney Disease (English and Spanish)
• Cuide sus riñones (only in Spanish)
• Los riñones sanos son riñones felices (English and Spanish)

Learn about the Chronic Kidney Disease Initiative

References

https://www.cdc.gov/kidneydisease/basics.html

*SGLT2 inhibitors are a class of medications used to treat type 2 diabetes.