How Can People With Diabetes Protect Their Kidney Health?: The kidneys filter waste products and excess fluid from the blood. They also help regulate electrolytes, blood pressure, and other important body functions.
Diabetes can damage the tiny blood vessels and filtering structures in the kidneys. Over time, this may lead to diabetic kidney disease, also called diabetes-related chronic kidney disease.
People with diabetes can help protect their kidney health through appropriate glucose management, blood pressure control, regular kidney screening, and individualised medical care. Early kidney disease often causes no symptoms, so screening is important even when you feel well.
How Does Diabetes Affect the Kidneys?
Persistently elevated blood glucose can place stress on the kidneys’ filtering system. Damage may cause albumin, a type of protein, to leak into the urine.
As kidney disease progresses, the kidneys may become less effective at filtering waste products from the blood.
However, kidney problems are not always caused by diabetes alone. High blood pressure, cardiovascular disease, certain medications, and other kidney conditions can also contribute.
What Are the Early Signs of Kidney Disease?
Early diabetic kidney disease often has no obvious symptoms.
In more advanced stages, symptoms may include:
- Swelling around the ankles, feet, or eyes.
- Changes in urination.
- Persistent fatigue.
- Nausea or reduced appetite.
- Difficulty controlling blood pressure.
These symptoms can have several causes. Do not wait for them to appear before having recommended kidney tests.
Which Kidney Tests Are Important?
Two commonly used tests help assess kidney health.
1. Urine Albumin-to-Creatinine Ratio
The urine albumin-to-creatinine ratio, or UACR, checks whether small amounts of albumin are leaking into the urine. An elevated result can be an early sign of kidney damage.
Temporary factors such as strenuous exercise, fever, urinary infection, and other conditions can affect results, so repeat testing may be needed.
2. Estimated Glomerular Filtration Rate
The estimated glomerular filtration rate, or eGFR, is calculated from a blood test, usually including creatinine. It estimates how effectively the kidneys filter blood.
A reduced eGFR may indicate impaired kidney function, but the result must be interpreted alongside other findings and, where appropriate, repeat testing.
For many people with Type 2 diabetes, kidney screening is recommended at diagnosis and at least annually. For Type 1 diabetes, screening commonly begins after five years of diabetes, with the frequency adjusted to individual risk and results.
Practical Ways to Protect Kidney Health
1. Manage Blood Glucose
Follow your prescribed diabetes treatment plan and attend recommended HbA1c checks. Appropriate glucose management can help reduce the risk of kidney damage.
Do not make medication changes without medical guidance.
2. Control Blood Pressure
High blood pressure can damage kidney blood vessels and accelerate kidney disease. Your clinician can help set an appropriate blood pressure target and recommend treatment if needed.
Some medicines, including ACE inhibitors or ARBs, are used for particular patients with diabetes, high blood pressure, or albuminuria. They are not suitable for everyone and require medical supervision.
3. Eat a Balanced Diet
A balanced eating pattern may include vegetables, suitable protein sources, and appropriate portions of carbohydrate-rich foods.
People with established kidney disease may need individual limits for sodium, protein, potassium, or phosphorus. Do not follow a restrictive kidney diet without professional guidance.
4. Be Careful With Painkillers and Supplements
Frequent use of some anti-inflammatory painkillers, such as ibuprofen or naproxen, can harm kidney function in certain circumstances, particularly with dehydration or existing kidney disease.
Some herbal products and supplements may also pose risks. Ask your clinician or pharmacist before using medicines or supplements regularly.
5. Avoid Tobacco and Stay Active
Avoiding tobacco and engaging in suitable physical activity support cardiovascular and metabolic health, which are closely connected to kidney health.
6. Follow Up on Abnormal Results
If urine albumin or eGFR results are abnormal, your healthcare professional can determine whether repeat testing, treatment adjustments, or referral to a kidney specialist is needed.
Should People With Diabetes Drink Extra Water to Protect Their Kidneys?
Staying adequately hydrated is important, but drinking excessive amounts of water does not reverse kidney damage. Fluid needs vary, especially in people with advanced kidney disease, heart failure, or a medical fluid restriction.
Follow your clinician’s advice about daily fluid intake rather than forcing yourself to drink a fixed amount.
Frequently Asked Questions
1. Can diabetes cause kidney failure?
Diabetes can cause progressive kidney damage in some people. However, appropriate treatment, regular screening, and management of risk factors can reduce the likelihood of progression.
2. Can diabetic kidney disease be reversed?
Some early abnormalities may improve with treatment, but established chronic kidney damage may not be fully reversible. Early detection is important.
3. Can I have kidney disease without symptoms?
Yes. Early kidney disease often causes no noticeable symptoms, which is why urine albumin and eGFR testing are important.
4. Should people with diabetes avoid protein?
Not everyone needs to restrict protein. People with chronic kidney disease may require individualised protein advice based on their kidney function, nutritional status, and treatment plan.
5. How often should kidney function be tested?
Screening is commonly performed at least annually for many people with diabetes, with earlier or more frequent testing depending on the diabetes type, results, and risk factors.
Conclusion
Protecting kidney health is an important part of diabetes management. Glucose control, blood pressure management, appropriate medication, and regular urine and blood tests can help detect kidney problems early and reduce the risk of progression.
For support with diabetes management and routine complication screening, consult Dr. Rajender’s Lifestyle Clinic, Banjara Hills, Hyderabad. Your healthcare team can help coordinate appropriate kidney tests and specialist care when needed.
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