The arrival of March is a sign that spring is on its way! March also happens to be National Kidney Month. That may not sound all that exciting, but your kidneys need some TLC, especially if you have diabetes. These two bean-shaped organs, which are about the size of your fist, sit below your rib cage on either side of your spine, and they deserve special attention.
Yes, the kidneys make urine, but they do so much more than that. For example, the kidneys remove waste and extra fluid from the body. They also remove acids made by cells, and keep a safe balance of water, salts and minerals (including sodium, calcium, phosphorus and potassium) in the blood. And, they make blood cells and various hormones that control blood pressure, and keep bones healthy. If your kidneys don’t work, numerous health problems can occur.
Fast facts about diabetes and kidney problems
- According to the Centers for Disease Control and Prevention (CDC), kidney disease can develop slowly and with few symptoms. You may not realize that you have kidney problems until the disease advances.
- Kidney disease goes by other names, including chronic kidney disease, CKD and diabetic nephropathy. A doctor who specializes in treating diseases and problems of the kidneys is called a nephrologist.
- Kidney diseases are the ninth leading cause of death in the U.S.
- About one in three adults with diabetes has chronic kidney disease.
- Every 24 hours, 160 people with diabetes begin treatment for kidney failure.
- Even prediabetes, the beginning stage of diabetes, can damage the kidneys
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Diabetes and kidney problems: know the risks
One of the most common complications of having diabetes is kidney disease. Blood sugars that are high over a long period of time can damage the millions of tiny blood vessels in the kidneys, which prevent the kidneys from working well.
People with diabetes are also more likely to have high blood pressure; high blood pressure, in turn, raises the risk of kidney disease. Other risk factors for kidney disease if you have diabetes include:
- Having heart disease
- Having a family history of kidney failure
- Having diabetes vision problems (diabetic retinopathy)
- Having diabetes nerve damage (diabetic neuropathy)
- Eating high-sodium foods
- Being overweight
- Not being active
- Being African-American, Asian American or Native American
Symptoms of kidney disease
In the early stages of kidney disease, there are usually no symptoms. The only way to know is to get your kidneys checked. Over time, however, certain symptoms will appear if kidney damage progresses. Symptoms may appear when at least 75% of your kidney function is lost. These include:
- Lack of appetite
- Trouble sleeping
- Weight loss
- Muscle cramps
- Swelling of the feet and ankles
- Shortness of breath
- Chest pain
- Worsening of high blood pressure
Ways to keep your kidneys healthy
No one wants to have kidney disease, and prevention is the goal. And you can prevent kidney disease! If you already have kidney disease, you can slow the progression. Here’s how:
- Make sure to get tested for kidney disease every year if you have type 2 diabetes or if you’ve had type 1 diabetes for five or more years.
- A urine test checks for protein in the urine (called microalbumin). A level of microalbumin above 300 mg/g creatinine can be a sign of kidney damage.
- A blood test is used to check how well your kidneys filter your blood, called GFR (glomerular filtration rate). A GFR of less than 60 could mean that you have kidney disease.
Meet blood sugar and A1C goals.
- For most people with diabetes, blood sugar goals are 80 to 130 mg/dl before meals and less than 180 mg/dl two hours after meals.
- The A1C goal for most people with diabetes is less than 7%. Have your A1C level checked at least twice a year or ideally, up to four times a year.
- Your goals may be different. Make sure you discuss your goals with your healthcare provider.
- Review your current diabetes treatment plan with your provider, too. Remember that your treatment plan may include taking diabetes medicines, monitoring your glucose levels, eating healthy and controlling carbohydrate intake and being active.
- Ask your provider about diabetes medicines called SGLT2 inhibitors and GLP-1 agonists. These medicines not only help manage blood sugars, but they can also benefit your kidneys and your heart.
- Speaking of monitoring, talk with you provider or a diabetes educator about when and how often to check your blood sugars. Monitoring with either a blood glucose meter or CGM (continuous glucose monitor) is the only way you will know if you are keeping your glucose levels at your goal.
Control your blood pressure.
- Blood pressure that is not at goal (usually less than 140/90 mmHg) can cause a heart attack, stroke and kidney disease. Find out what your blood pressure goal should be.
- Make sure your blood pressure is checked at every regular provider visit and ask for your blood pressure numbers.
- Consider checking your blood pressure at home with a home monitor; you can purchase blood pressure monitors at your drugstore or online.
- Your provider may prescribe medicines that lower your blood pressure and that can slow kidney damage. Two types of medicines that help your blood pressure and your kidneys are ACE inhibitors and ARBs. If you’re not currently taking either of these medicines, ask your provider if you should start.
- If you smoke, make a plan to stop. Smoking can affect medicines that treat high blood pressure, slow blood flow to the kidneys, and raise the risk of having a heart attack or a stroke.
- Smoking can also slow blood flow to your feet, which makes it harder for your body to heal cuts, sores or infections.
- Eating to prevent kidney disease will help you manage your diabetes, blood pressure and cholesterol levels.
- Control how much carbohydrate you eat at meals and snacks. The goal isn’t to stop eating carbs altogether, but to limit the amount and also aim to eat about the same amount every day. Doing so makes it easier to manage your blood sugars.
- Aim for less than 2,300 milligrams of sodium daily. Limit processed foods that tend to be high in sodium, such as canned soups and vegetables, luncheon meats, salty snack foods and fast foods.
- Season foods with herbs and spices rather than salt.
- Make a point to include vegetables and fruit in your eating plan every day.
- Bake, broil or grill foods instead of frying.
- Use healthy fats, such as olive oil and canola oil, instead of butter, lard and shortening.
- Learn more about the DASH eating plan to help you lower your blood pressure.
- If you feel confused about what and/or how much to eat, ask your primary care provider for a referral to a registered dietitian nutritionist for more guidance.
- Doing some type of physical activity most days of the week will help you more easily manage your blood sugars and your blood pressure.
- Talk with your provider before starting any exercise plan if you have not been active.
- Think about activities that you like to do, such as walking, dancing or swimming.
- Find ways to fit more activity into your day. For example, march in place while watching TV, go up and down stairs a few times or walk around while you’re on the phone. You can even do “deskercises” while you’re working. Learn more about deskercises here.
- According to the National Kidney Foundation, “Staying well hydrate helps your kidneys clear sodium, urea and toxins from the body.”
- The U.S. National Academies of Sciences, Engineering, and Medicine has determined that an adequate daily fluid intake is roughly 15.5 cups for men and 11.5 cups for women (including water, other beverages and water from food). Talk with your provider if you’ve been told to limit your fluid intake.
- Flavor your water with slices of lemon, lime or cucumber for a refreshing change.
Go easy with NSAIDs.
- NSAIDS are nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen. They can injure the kidneys and may cause progression of kidney disease.
- NSAIDS can also interfere with ACE inhibitors, ARBs and diuretics.
- Talk with your provider about alternatives to NSAIDS if you take them for aches and pains.
- Stress and depression can make it harder to manage your blood sugars and your blood pressure.
- Being physically active is a great way to lessen stress and help manage depression.
- Try to fit relaxation into your day even if it’s for brief amounts of time. Breathing exercises, muscle relaxation, reading or spending time with your pet are some suggestions for how to relax.
- Set goals and priorities for your day. Learn to say “no.”
- Stay connected with family, friends or community organizations, even if it’s by telephone or video chats.
- Ask for help from a mental health professional if stress is overwhelming you.
Want to learn more about keeping your kidneys healthy with diabetes? Read “Protecting Your Kidneys,” “Kidney Disease: Your Seven-Step Plan for Prevention” and “Ten Things to Know About Kidney Disease.”