Have Diabetes? Reduce Your Risk of Kidney Disease

Chances are that when you worry about diabetic complications, kidney disease is at the top of your list. But diabetes is the leading cause of kidney disease (also called microalbuminuria) in the United States.

The disease damages these amazing organs, which function as filters in the body and remove waste products from the blood. When blood sugar levels are chronically elevated, the tiny blood vessels in the kidneys start filtering too much blood and ultimately, the kidneys can fail.

But just because you are diabetic does not mean you'll necessarily develop kidney disease, and there are measures you can take to prevent or at least delay its onset. Here's what to do to stay healthy. 

  • Get your urine checked for protein at least once a year, says Betsy Dokken, NP, Ph.D., an assistant professor of medicine at the University of Arizona in Tucson. It's an easy test (involving just a urine sample on your part) and it tells the doctor if your kidneys are starting to leak protein into the urine. This condition can be treated and may keep kidney disease from worsening.
  • Keep your blood pressure in the normal range, Dokken advises. Normal, she notes, means 130/80 and this is the number you should be aiming for. To lower your blood pressure, consume less salt, get regular exercise, avoid smoking and drinking alcohol, and lose weight if you are overweight, recommends the American Diabetes Association.
  • Keep your blood sugar in the target range. Good blood sugar control can cut the risk of developing early kidney disease by one third, according to the American Diabetes Association. And those who already have early kidney disease can reduce their risk of having it lead to full-blown kidney disease by maintaining tight blood sugar control.
  • Is there an accurate way to check whether you're in good control? "We use the hemoglobin A1C test to monitor how well someone is controlling their diabetes," says Dokken. "I recommend having this test every three months if the previous test was not in the target range, and otherwise, at least every six months." While the "target range" for a hemoglobin A1C isn't set in stone, Dokken says it should be below seven percent for most people.
  • Be prepared to start taking an oral medication like an ACE inhibitor. They're beneficial for preventing or delaying kidney disease, Dokken says, and typically they're taken just once a day in pill form.
  • You may be directed to follow a low-protein diet. Since protein appears to make kidneys work harder, a low-protein diet is believed to cut protein loss in the urine and bump up the protein levels in the blood. But, cautions the American Diabetes Association, don't put yourself on a low-protein diet. Consult your doctor first.

American Diabetes Association: Living with Diabetes: Kidney Disease (Nephropathy)