Diabetes and kidneys: Tips for protecting your future health

With so many daily management considerations to take into account, the subject of diabetes and kidney health can feel like one more thing to add to your list. We completely understand!

Over time, you've likely gotten used to maintaining your blood sugars as well as addressing highs and lows. And now, you may have a stream of thoughts in the back of your mind, reviewing everything from when your last insulin injection was to whether you can make it through your planned workout without stopping for a snack.

It takes a lot of mental effort to keep your blood sugar in check, but you've got your long-term health to think about too! It's important to make sure chronic complications of diabetes don't end up causing problems — and your kidneys play a major role.

Here's what you need to know about the relationship between diabetes and kidneys while living a full, healthy life.

How does diabetes affect the kidneys?

Like the eyes, the kidneys are able to absorb glucose (sugar) on their own, even if there is no insulin available to help them do it. This makes the kidneys vulnerable to high blood sugar levels.

When the smallest blood vessels in the kidneys are exposed to high levels of glucose, they can be damaged. As a result, the body stops using those damaged blood vessels and tries to build new blood vessels instead.

When this happens, the kidneys are not able to work as efficiently. Because the kidney's job is to filter toxins from the blood, inefficient kidneys can have negative consequences for overall health.

4 ways people with diabetes can prevent kidney disease

Taking care of both your diabetes and kidneys is vital to your future health. More than 35 percent of adults with diabetes have kidney disease, but you don't have to be in that percentage. Here are several measures you can take to avoid kidney disease:

1. Keep blood sugars under control. This prevents microvascular damage (damage to the smallest blood vessels) in the kidney. An A1C of less than 7 percent is a good goal for most people. One of the best tools available to help you manage your blood sugars is a continuous glucose monitor (CGM). A CGM is a wearable device that allows you to check your blood sugar multiple times a day without pricking your finger. Some CGMs will alert you to an upcoming high or low blood sugar event so you can adjust your food or insulin dosage before your glucose levels get significantly out of range.
2. Keep your blood pressure in check. The kidneys are sensitive to high blood pressure and can be damaged if blood pressure is not well-managed. The American Diabetes Association recommends that anyone with diabetes and high blood pressure consider the use of an ACE inhibitor or an ARB. ACE inhibitors and ARBs are blood pressure medications that have been shown to reduce the risk of kidney damage in people with diabetes.
3. Avoid drinking too much alcohol. Alcohol is tough on the kidneys because they have to work harder to filter alcohol out of the bloodstream. Alcohol also causes dehydration, and that's hard on all the body's cells, including the kidneys. Regular "heavy" drinking (which is considered four or more drinks) doubles your risk of kidney disease. To be safe, the recommended limit for alcohol consumption is one drink per day for women or two drinks per day for men.
4. Stay away from illegal drugs. Recreational drug use — especially cocaine, heroin and amphetamines — can also cause kidney damage. Some recreational drugs raise the body's temperature to levels that can permanently damage organs. Others cause severe dehydration, and some cause the rapid breakdown of muscle tissue, leading to a condition called "rhabdomyolysis." Rhabdomyolysis puts extreme stress on the kidneys as they work to clear the broken-down muscle tissue from the bloodstream.

Treatments available for people with diabetes and kidney disease

In the early stages of kidney disease caused by diabetes, most people take a variety of oral medications as well as insulin, if needed. The oral medications might include the ACE inhibitors or ARBs (as mentioned above, to control blood pressure), cholesterol-lowering medications, drugs to help maintain bone health, and medicine to help prevent the body from losing protein through urine.

If kidney disease worsens, dialysis will need to be considered. Dialysis is the process of removing toxins from the blood with an external procedure, as opposed to relying on the kidneys to do the job. There are two main types of dialysis: peritoneal dialysis, which can be done at home, and hemodialysis, which is usually done in an outpatient center. A patient typically visits a hemodialysis center for several hours, three times per week.

By paying attention to your blood sugars, blood pressure, and alcohol intake, you can effectively protect your kidneys now — and long into your future.

Looking to read up on other aspects of living with diabetes? Explore the Edgepark HealthInsights blog to access the library of helpful advice and insightful articles.