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Preventing Kidney Disease When You Have Diabetes
Have You Thought About Your Kidneys Today?
Ever thought about what high-tech little machines the kidneys are? The science of how kidneys
work is pretty complicated, but their purpose is simple and important: they’re the body’s filters.
The kidneys process about 200 quarts of blood each day, and filter about two quarts of waste
products and extra water from the body. When kidneys are damaged, they lose their filtering
ability.
High blood sugar and high blood pressure are the two main causes of kidney disease.
Most kidney disease happens slowly over time. And it can take years before you might notice
any symptoms. Here’s what diabetes does to the kidneys: If glucose (the form of sugar in your
blood) stays in your blood instead of breaking down, it can act like a poison. Damage to the
kidneys from too much glucose in the blood is called diabetic nephropathy (nef-ROP-uhthee). If you keep your blood glucose and blood pressure at normal levels, you can help
prevent or delay diabetic nephropathy.
How can your doctor tell if you might get kidney disease? The most sensitive test for early
kidney disease is urine albumin(al-BYOO-min). The earliest stage of albumin in the urine is
called microalbuminuria (mykrow-al-byoo-min-yur-ee-ah). People with diabetes should have
two simple tests each year to check for kidney disease including a blood test for creatinine
(kree-at-in-nin) and a urine test for albumin..
What are the symptoms of kidney disease?
Most people do not have severe symptoms until kidney disease worsens. Tell your doctor if you
notice any early warning signs:
Feeling more tired • Trouble sleeping • Muscle cramping at night • Poor appetite • Swollen feet
and ankles • Dry, itchy skin • Puffiness around your eyes, • Urinating more often, especially in
the morning especially at night.
Right now, there is no cure for diabetic kidney disease, but treatment can keep it from getting
worse. That is why it is so important to prevent kidney disease from occurring in the first place.
Prevention
You can avoid or delay kidney disease, and your kidneys can work better if you control your
diabetes. To do that, you should:

Keep your blood pressure at 130/80. 120/70 is even better.

Keep your blood sugar levels down. Your A1C should be less than 7%. 6.5% or lower is
recommended. To understand more about A1C levels, read the informational pamphlet “If
You Have Diabetes, Know Your Blood Sugar Number”, published by the National
Diabetes Education Program, in the General Diabetes Information section of this tool kit, or
click on the following link: http://www.ndep.nih.gov/diabetes/pubs/KnowNumbers_Eng.pdf

Do not take medicines that may hurt the kidneys. These include ibuprofen and some other
pain killers and anti-inflammatory products. Ask your doctor about other medicines that may
be harmful to your kidneys.

Get checked for urinary tract infections. Get treatment if you have one.

Get a microalbumin test each year. To do this test, your doctor will take a sample of your
urine to see how much protein is present. Too much protein in the urine is an early sign of
kidney disease. Ask your doctor about the results of your microalbumin test and what they
mean.
TIP:
What is GFR? And why is it important for kidney health?
GFR is short for Glomerular (gloh-MEHR-yoo-ler) Filtration Rate. It is one of the best tests to
measure how much kidney function you have. Uncontrolled diabetes can cause your kidneys’
filtering ability to slow down. Have your blood tested at least once a year for creatinine (kree-ATih-nin). The result of this test should be used to estimate your GFR. The earlier kidney disease
is detected, the better the chance of slowing or stopping its progression.
Sources:
American Diabetes Association – www.diabetes.org
National Kidney Foundation. Diabetes and Kidney Disease. http://www.kidney.org/atoz/atozItem.cfm?id=145. Accessed 04/25/2007. Schoolwerth AC,
Engelgau MM, Hostetter TH, Rufo KH, Chianchiano D, McClellan WM, et al. Chronic kidney disease: a public health problem that needs a public health
action plan. Prev Chronic Dis [serial online] 2006 Apr http://www.cdc.gov/pcd/issues/2006/apr/05_0105.htm. Accessed 04/25/07. NIH Publication No.
06-4241,
http://search2.google.cit.nih.gov/search?site=NIH_Master&client=NIHNEW_frontend&proxystylesheet=NIHNEW_frontend&output=xml_no_dtd&filter=0
&getfields=*&q=publication+no.+06%964241&btnG.x=28&btnG.y=10, November 2005, http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/.
Accessed 04/25/07. National Kidney Foundation, http://www.kidney.org/kidneydisease/ckd/knowGFR.cfm, American Kidney Fund, Understanding Your
Lab Results: GFR (Glomerular Filtration Rate), http://www.kidneyfund.org/pdf/GFR-Fact-Sheet.pdf. Accessed 04/25/07