Diabetes is the leading cause of kidney failure in the United States. Over time, high blood sugar can damage the tiny filters in the kidneys. The good news is that early testing and today’s treatments can greatly lower the risk of kidney disease getting worse.
How diabetes affects the kidneys
Each kidney has about a million small filters called nephrons. High blood sugar and high blood pressure can damage these filters, so they start to leak protein (albumin) into the urine and slowly lose the ability to clean the blood. This is called diabetic kidney disease. It usually causes no symptoms until it is advanced.
Get tested every year
If you have diabetes, ask for these two tests at least once a year:
- Urine albumin-to-creatinine ratio (UACR) to check for protein in the urine, often the earliest sign of kidney damage
- eGFR, a blood test that shows how well your kidneys filter
Read more in Understanding your kidney lab results.
How to protect your kidneys
- Keep blood sugar in your target range. Your A1C goal should be set with your care team.
- Control blood pressure. High blood pressure speeds up kidney damage in people with diabetes.
- Ask about kidney-protective medicines. Several medicines used for diabetes and blood pressure have been shown to slow kidney disease and protect the heart. Your doctor can tell you whether they fit your situation.
- Review your medicines. Some diabetes medicines need a lower dose or must be stopped as kidney function changes. Do not stop or change a medicine without talking to your doctor.
- Avoid NSAID pain relievers such as ibuprofen and naproxen unless your doctor approves them.
- Stay active, eat well, and do not smoke.
When to see a kidney specialist
Your primary care doctor may refer you to a nephrologist if your eGFR is falling, your urine albumin is high or rising, your blood pressure is hard to control, or the cause of your kidney disease is unclear.
Questions to ask at your visit
- Do I have signs of diabetic kidney disease?
- What are my UACR and eGFR results?
- Am I on medicines that protect my kidneys?
- Do any of my diabetes medicines need to be adjusted for my kidney function?
This guide is general education and is not a substitute for medical advice. Talk with Dr. Salim or your care team about your own situation. Informed by patient materials from the National Kidney Foundation; learn more at kidney.org.