Some people with type 2 diabetes develop kidney disease. This is a common diabetes complication, usually caused by high blood sugars and glucose fluctuations over time.
Kidney disease is one of the most serious complications that many people with diabetes may experience. It’s the
DKD can cause end stage kidney disease (ESRD), which occurs when the kidneys no longer work effectively. More than
Diabetic nephropathy has few early symptoms or warning signs. Kidney damage from nephropathy can occur for as long as a decade before the first symptoms appear.
Often, no symptoms of kidney disease appear until the kidneys are no longer functioning properly. Symptoms that indicate your kidneys could be at risk
- fluid retention
- swelling of your feet, ankles, and legs
- decreased appetite
- frequent exhaustion and weakness
- frequent headaches
- upset stomach
- nausea
- vomiting
- insomnia
- difficulty concentrating
Early diagnosis of kidney disease is essential for your health.
Genetics
If you have prediabetes, type 2 diabetes, or other known diabetes risk factors, your kidneys are already overworked, and their function should be tested each year.
Other risk factors for kidney disease
- high blood pressure
- high blood glucose
- obesity
- high cholesterol
- a family history of kidney disease
- a family history of heart disease
- cigarette smoking
- advanced age
- certain ethnicities, including African Americans and Indians
Kidney disease doesn’t have just one specific cause. Experts believe its development is likely associated with years of unregulated blood glucose. Other factors, such as genetic predisposition, likely play important roles as well.
Over time, having high blood glucose can damage the blood vessels in your kidneys. Damaged blood vessels may work less effectively.
High blood pressure can also contribute to kidney damage, and many with diabetes can
If you have DKD, treatment involves preserving your kidney function. Steps that doctors may recommend
- Managing high blood pressure: If you have high blood pressure, a healthcare professional may prescribe medication to help lower your blood pressure. Eating low sodium, heart-healthy foods and taking your medications as prescribed may help you reach your blood pressure goal.
- Managing your blood glucose levels: Check your blood glucose levels regularly. Keeping your daily blood glucose levels close to the levels your doctor recommends may help preserve your kidney function.
- Taking prescribed medication: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), two types of blood pressure medication, may help slow kidney disease progression, even in people without high blood pressure. Your medication and dosage may change over time.
Other lifestyle habits that may help you manage kidney disease
- following a healthy eating plan for diabetes or working with a registered dietitian
- getting 30 minutes or more of physical activity each day
- quitting smoking, if you smoke
- getting at least 7 to 8 hours of sleep each night
- finding ways to cope with stress, which can contribute to high blood pressure
- seeking support or treatment for depression, if you experience it
If you have kidney failure, treatment may involve dialysis or a kidney transplant.
Learn more
This is what dialysis means for those with kidney disease.
Certain people with end-stage kidney disease may also be eligible for a kidney transplant.
The
Eating habits
A key way to preserve kidney health is to be mindful of your diet. People with diabetes who have partial kidney function need to be even more vigilant about managing their:
- blood glucose levels
- blood cholesterol levels
- lipid levels
Most people should aim to maintain a blood pressure of 120/90 mm Hg or less. The doctor treating your high blood pressure may recommend an individual goal. Even if you have mild kidney disease, high blood pressure can cause the disease to progress more quickly.
A doctor may recommend that you:
- eat foods low in salt
- avoid adding salt to meals
- maintain a moderate weight, or lose weight if you’re overweight or have obesity
- avoid drinking alcohol
A doctor may recommend that you eat more or less protein depending on how severe your renal disease and kidney disease may be.
Physical activity
Getting
Exercise has the added benefit of stress relief, which can help lower blood pressure.
Talk with your doctor about the type and intensity of physical activity that would be best for you.
Medication
Most people with type 2 diabetes who have high blood pressure take ACE inhibitors for heart disease treatment, such as captopril and enalapril (Vasotec). These drugs also have the potential to slow the progression of kidney disease.
Doctors also commonly prescribe ARBs.
Sodium-glucose cotransporter-2 inhibitors (SGLT-2s) and glucagon-like peptide-1 receptor agonists (GLP-1s) are other possible medication options for people with type 2 diabetes and CKD. These drugs can reduce the risk of CKD progression and cardiovascular events.
Stopping smoking
If you smoke cigarettes, consider seeking support for quitting.
Smoking is a risk factor for diabetic nephropathy. It can make kidney damage worse.
Diabetic nephropathy is a serious complication of both type 1 and type 2 diabetes. It occurs when your kidneys lose their ability to effectively filter waste from your blood over time.
Maintaining healthy blood pressure and blood glucose levels may help prevent or slow the progression of diabetic nephropathy. A doctor may prescribe medications to help preserve kidney function.
If you have kidney failure, you may undergo dialysis to filter waste from your blood.