Diabetic kidney disease: tests, risks and protecting your kidneys

Kidneys filter waste from the blood, and diabetes can slowly damage them. The early stages usually cause no symptoms, so regular testing matters. This article explains what the NIDDK and NHS say about diabetic kidney disease, in plain language.

What is diabetic kidney disease?

The NIDDK describes diabetic kidney disease, also called diabetic nephropathy, as kidney disease caused by diabetes. High blood glucose can damage the blood vessels in the kidneys. High blood pressure, which often goes along with diabetes, can add to the damage. The NIDDK says diabetes is the leading cause of kidney disease. The NHS also lists kidney problems among the possible long-term complications of diabetes.

Symptoms

According to the NIDDK, most people with diabetic kidney disease have no symptoms, and testing is the only way to know if you have it. This is why waiting for symptoms is not a safe plan.

Who is more at risk?

The NIDDK lists these risk factors:

• Living with diabetes for a longer time
• High blood glucose or high blood pressure
• Smoking, not following a diabetes eating plan, high-salt eating, inactivity and being overweight
• Heart disease or a family history of kidney failure
• Higher rates in African American, American Indian and Hispanic/Latino communities

How is it found?

The NIDDK says clinicians check the urine for a protein called albumin and run a blood test to assess how well the kidneys filter the blood. It recommends yearly testing for people with type 2 diabetes, and for people with type 1 diabetes that has lasted more than 5 years. The NHS adds that kidney checks are among the annual checks for people with type 2 diabetes, along with weight, cholesterol and blood pressure.

Ways to protect your kidneys

The NIDDK describes these general steps. Your own doctor will set your goals.

• Work toward your blood glucose goals. An A1C below 7% is a common goal, but your care team will advise on yours.
• Work toward your blood pressure goals. The NIDDK cites below 140/90 mm Hg for most people with diabetes, and the NIDDK's managing diabetes page says some people may have a lower goal of 130/80.
• Ask about medicines. The NIDDK says certain blood pressure medicines, called ACE inhibitors and ARBs, can slow kidney damage in people with diabetes, high blood pressure and kidney disease. They are not safe during pregnancy. A doctor decides whether they are right for you.
• Choose healthy habits. Quit smoking, limit salt, follow a diabetes meal plan, be active, aim for a healthy weight and sleep 7 to 8 hours a night.
• Manage stress. The NIDDK says stress can raise both blood glucose and blood pressure.

Why check-ups matter

Because there are no early symptoms, the NHS stresses attending all diabetes appointments and not skipping tests so problems can be caught early. Bring your results to each visit and ask what they mean for you.

Living with diabetes and kidney disease

If kidney disease is found, your doctor will explain next steps, which may involve specialists. The NIDDK recommends working with your health care team on a treatment plan. A dietitian or diabetes educator can help with a meal plan that suits both conditions, since the NIDDK's managing diabetes page lists them as part of the care team.

When to see a doctor

Ask your doctor when you last had a urine albumin test and a blood test for kidney function, especially if you have had diabetes for years or have high blood pressure. Because early disease has no symptoms, do not wait for signs before asking about testing.

Seek urgent care for severe symptoms such as trouble breathing, confusion, fainting, or stomach pain with vomiting. In an emergency, call your local emergency number (112 in India, 911 in the United States).

This article is for education only and does not replace advice from your own doctor.