Chronic kidney disease is a common complication of type 2 diabetes, but not everyone with diabetes develops it. Certain risk factors, like diabetic neuropathy and hypertension, can increase the chance of developing chronic kidney disease in type 2 diabetes.
Type 2 diabetes (T2D) is a metabolic disorder defined by elevated blood sugar levels, or hyperglycemia. It occurs when your body becomes resistant to insulin, a hormone necessary for helping glucose (sugar) from foods enter cells and be used for energy.
When blood sugar levels remain too high for too long, they can start to negatively affect your tissues and organs, including your kidneys. High blood sugar can damage the delicate blood vessels in your kidneys, affecting their function. When kidneys gradually and progressively lose function over time, it’s known as chronic kidney disease (CKD).
While T2D is a risk factor for CKD on its own, several other factors in T2D can increase your chance of having both of these medical conditions.
Risk factors are variables that affect the likelihood of developing a medical condition like CKD. In T2D, your kidneys may already be at risk for CKD, but other medical conditions and lifestyle factors also matter.
How long you’ve lived with T2D and how long it’s been untreated can affect your chance of developing CKD.
The longer you’ve been living with T2D, the more time high blood sugar levels have to cause damage in your body, and the more likely you are to have additional T2D complications like diabetic retinopathy that increase CKD risk.
If T2D isn’t managed, persistently high blood sugar levels can cause damage more rapidly than when T2D is managed.
The same processes that can damage the vessels of your kidneys in T2D can cause damage and structural changes to vessels throughout your body.
Over time, damaged vessels narrow and constrict, losing their flexibility and restricting blood flow, raising blood pressure. Low-grade inflammation from T2D and high insulin levels in the bloodstream can also affect vessel constriction and contribute to hypertension (high blood pressure).
Hypertension can worsen the damage in your kidneys by straining already vulnerable vessels. As kidney function declines and the kidneys can’t remove excess fluids form you body, blood pressure can increase even further.
High blood pressure is the
Leading a sedentary life or one without adequate exercise and activity is a risk factor for CKD, even among people without other underlying medical conditions.
A sedentary lifestyle contributes to CKD through factors like increased systemic inflammation, weight gain, increased insulin resistance, and inadequate circulation.
According to a population-based study in 2023, nearly half of all people with reduced kidney function lead sedentary lifestyles, defined as sitting for more than 6 hours per day. Sitting for this long every day is associated with an increased risk mortality rate for people diagnosed with CKD.
Diabetic retinopathy, a complication of T2D, occurs when high blood sugar damages the tiny blood vessels in the retina of the eye, affecting vision.
While diabetic retinopathy doesn’t directly cause CKD, having diabetic retinopathy can indicate that you’re at an increased risk of CKD. If the small vessels of your eyes have already been damaged, there’s a good chance the small vessels of your kidneys are also being affected.
A 2021 retrospective cohort study found diabetic retinopathy was associated with a higher prevalence of kidney disease and risk of CKD.
In T2D, damage to blood vessels caused by elevated blood sugar levels can affect how well the kidneys regulate fluid balance in the body. Damaged vessels can’t eliminate excess fluids efficiently, causing hypervolemia (fluid overload) and swelling, known as edema.
If you’re experiencing edema, it can be a sign that your blood vessels are already damaged and kidney function is being affected by T2D changes. Edema can further increase blood pressure and promote inflammation, which can worsen kidney damage.
Both T2D and CKD are serious, long-term medical conditions, and living with both simultaneously is associated with less favorable health outcomes. According to a review from 2021, approximately 40% of people with T2D experience long-term kidney challenges.
If you’ve been diagnosed with T2D, timely treatment and effective management are key to preventing or reducing damage that leads to CKD.
T2D is managed through medications to control blood sugar and lifestyle modifications like weight loss, exercise, and a balanced diet. Regular glucose monitoring and check-ins with your doctor help ensure T2D is as controlled as possible.
If you are diagnosed with CKD alongside T2D, your doctor will add strategies to your treatment plan that focus on addressing concerns like high blood pressure, electrolyte imbalances, and waste buildup in the bloodstream. You may need dialysis or blood filtration in the later stages of CKD, or a kidney transplant might be necessary.
If you have T2D, it’s never too early to talk with your doctor about strategies to prevent CKD. Modifiable risk factors you can improve include:
- getting plenty of exercise
- weight management
- balanced diet
- quality sleep
- smoking cessation
CKD is a common complication of T2D. Over time, high blood sugar can cause damage to the tiny vessels in your kidneys, causing various functional changes that impact how effectively they filter blood and remove excess fluid from the body.
Not everyone with T2D develops CKD, but you may have a higher risk if you’ve been living with T2D for a long time, have uncontrolled T2D, or are experiencing symptoms like hypertension, edema, or diabetic retinopathy.
Speaking with your doctor about CKD at the time of your T2D diagnosis can help you prevent kidney problems in the long run.