Dr. Ahmed As a leading cause of death, diabetes is a silent killer, and it causes devastating complications, one of which is kidney disease. It is the main reason for chronic kidney disease (CKD) in most developed and developing nations.
Nearly 20% of people with type 2 diabetes develop signs of kidney damage related to diabetes within 20 years of having the condition.
This is why it is important for people to learn strategies and lifestyle changes that can restrict their chances of developing any renal abnormality.
How is diabetes linked with kidney disease?
There are two bean-shaped organs located on either side of your spine called kidneys. They play a rather important role in filtering waste products and leftover body fluids from the blood.
Similarly, regulating blood pressure, electrolyte balance, and red blood cell production is also one of their key functions.
In diabetic people, their high blood glucose levels can ultimately damage the tiny blood vessels in the kidneys, which will lead to a condition called diabetic nephropathy.
Over the passage of time, this damage can destroy kidney function and eventually cause renal failure.
When the kidneys are not capable of filtering waste products properly, they can build up in the blood, causing a bunch of health problems, including:
- Nausea and vomiting
- Loss of appetite
- Fatigue
- Weakness
- Shortness of breath
- Swelling in the legs and ankles
- Confusion
- Seizures
- Coma
Please note that these signs and symptoms of diabetic nephropathy may not appear until the condition is advanced. So, it is better to monitor your kidney health regularly, even if you do not have symptoms.
Preventing Diabetic Nephropathy: 6 Key Interventions
Here are a few strategies you can use to prevent kidney damage and take care of your renal health.
1. Maintain control of your blood sugar:
This is the most important factor in preventing kidney damage [ref]. Work genuinely with your healthcare physician to get a personalized diabetes management plan that has regular blood sugar monitoring, medication, and dietary adjustments included in it.
2. Manage your blood pressure:
While high blood sugar can already put too much pressure on your kidneys, to make it worse an increased blood pressure can totally impair kidney function.
For this reason, you need to take prescribed blood pressure medications as suggested by your doctor. You must also follow your physician’s recommendations for any lifestyle changes like reducing sodium intake and increasing physical activity.
3. Monitor your kidney function:
Keep a close eye on your kidney function as both organs are under strain in diabetes. Try to detect any signs and symptoms while getting urine and blood tests done. This will help with the early detection of proteinuria (a sign of kidney damage).
4. Adopt a healthy lifestyle:
No matter what disease or condition we talk about, a healthy lifestyle is the best way to prevent it. You can protect your overall health and not just kidney function with some exercise, a balanced diet, avoiding alcohol, etc.
Salt and protein restriction is essential in patients with ongoing and advanced kidney disease.
5. Quit Smoking:
Smoking is associated with a number of health hazards. Smokers have been found to have a rapid progression of diabetic kidney disease compared to non-smokers.
Smoking cessation can have a profound impact on a person living with diabetic kidney disease. It is associated with a reduced risk of atherosclerosis and oxidative stress which are key factors in the progression of diabetic kidney disease.
6. Avoid Nephrotoxic Drugs:
Nephrotoxic drugs, especially NSAIDs or pain medications, can damage the kidneys. Although, NSAIDs can damage the kidneys in diabetics and non-diabetics equally, patients with diabetes are more vulnerable to progressive kidney damage.
Kidney disease prevention through diabetes medications
There are many diabetes medications that can also help protect your kidneys. These drugs often work by improving blood sugar control and reducing blood pressure. Some examples include:
| Diabetes Medications | Functions |
|---|---|
| Metformin | In addition to lowering blood sugar levels, metformin may also have good effects on kidney function. |
| ACE inhibitors and ARBs | These ones are mostly used to help with high blood pressure and can also help protect the kidneys by reducing proteinuria. |
| SGLT2 inhibitors | These meds lower blood sugar levels by helping the kidneys excrete extra glucose in the urine. They may also have good effects on kidney function. |
| GLP-1 receptor agonists | These can help better your blood sugar control and may also have protective impacts on the kidneys. |
Note: It is rather necessary to contact your healthcare provider and determine which drug is the best for you if you are at risk of kidney disease. The physician will prescribe the one that suits your needs the best.
Recently, Finerenone, a non-steroidal MRA (mineralocorticoid receptor antagonist) has been approved for the treatment and prevention of diabetic kidney disease.
Kidney disease prevention through diet
Control Blood Sugar Levels: A balanced diet that is full of fruits, vegetables, whole cereals, and lean meat can help manage blood sugar levels, lowering the risk of kidney damage.
Limit Sodium: Excessive sodium intake can basically cause high blood pressure, which can put pressure on the kidneys [ref]. You must control and limit your consumption of processed foods and salty snacks.
Moderate Protein Intake: While protein is obviously needed for good health, consuming too much can put strain on the kidneys. It’s best to seek advice from a dietitian for recommendations tailored to your specific needs.
Stay Hydrated: Proper hydration is needed for kidney health. Drink plenty of water throughout the day to help flush out toxins.
Avoid Excessive Alcohol: Too much alcohol intake can damage the liver and kidneys. It is better to limit alcohol intake, but it is best to avoid it altogether.
Berberine has been shown to improve kidney functions in small trials. However, consult healthcare providers before initiating any off-label supplements or medications
Simply by following these strategies, you can properly reduce any chances of kidney damage. Do not hesitate to reach out to your healthcare provider if you are concerned about any signs or symptoms.
Remember that early diagnosis and prevention are rather important for maintaining a healthy life with diabetes.
