Diabetes and kidneys

The kidneys are the body’s filters, and they help eliminate waste products from the body. In the video below, Dr Alex Bickerton explains how diabetes can affect the kidneys, how you can reduce your risk of developing problems and what the treatments are for people with diabetic kidney disease.

High blood glucose levels over a prolonged time can cause damage to the kidneys. The kidney’s filtering process can become leaky, and over time kidney function can decline, leading to a build-up of waste products. 

Screening for Kidney Disease 

People with diabetes are recommended to have annual check-ups to detect the early changes associated with kidney damage. At these check-ups, a urine test, a blood test, and blood pressure check are done. 

The urine test is to look for protein; there should normally be none present, as the kidneys filter does not allow it through. However, people with diabetic nephropathy have a leaky filtering system and protein can be found in the urine. 

The blood test is to look for waste products in the blood that should not be present if the kidneys are doing their job correctly.  

Blood pressure should also be monitored as increased blood pressure can aggravate and accelerate further damage to the kidney.

These tests combined aim to pick up any kidney problem at an early stage. 

Reducing the Risk 

There are 4 factors that you can change to prevent or slow down the progression of most diabetes complications including diabetic kidney disease:

• improving diabetes glucose control

• controlling blood pressure

• aiming for a healthy weight

• stopping smoking if you are a smoker

Medication 

Sometimes a tablet called an ACE inhibitor or an Angiotensin Receptor Blocker (drugs ending in the names ‘sartan or ‘opril) may be prescribed to protect the kidney. Occasionally further kidney decline can occur and although very rare, diabetes is still, unfortunately, the leading cause of kidney dialysis and transplantation.