Diabetic Kidney Disease - Treatment, Management, and Prevention
Diabetic kidney disease causes damage to the body's tiny blood vessels, and these injuries impair the kidneys' ability to adequately filter blood. When your kidneys are not functioning, ankle edema and weight gain may arise from your body retaining more salt and water than it should. Additionally, waste products will accumulate in your blood if your kidney function keeps deteriorating!
Diabetes might harm your nerves as well, and passing urine may become difficult as a result. What’s more, your kidneys might be harmed by the pressure that builds up from a full bladder! Germs that multiply quickly in urine with high sugar content might cause an infection if they stay in your bladder for an extended period of time.
Today, the number of diabetic people is increasing worldwide at a frightening rate, and in India, the situation is no different. 40% - 60% of diabetics in India have chronic kidney disease (CKD), a serious consequence of type 2 diabetes! Keep reading to find out more to understand how diabetes affects your kidneys and what diabetic kidney disease prevention methods you can follow to keep yourself healthy!
What is Diabetic Kidney Disease?
Diabetes-related complications impact the kidneys if blood sugar remains high for a long period of time! This is called diabetic kidney disease (DKD), also known as diabetes nephropathy. Waste is removed from your body by your kidneys, and nitrogen waste products like urea, muscle waste (creatinine), and several other similar waste products are regularly removed through this process. More than a million nephrons are found in each kidney, which aids in blood filtration and maintains equilibrium, which means the fluid and electrolyte balance in your body is also aided by your kidneys.
Glomeruli are collections of microscopic blood vessels found in each nephron,n and glomeruli carry out the initial stage of blood filtration. Your body cannot effectively handle glucose, or blood sugar, from the meals and beverages you ingest if you have diabetes, and an excess of glucose in the blood can harm the glomerular membranes and other nephron components. Damaged glomeruli cannot adequately filter fluids and toxins that need to be eliminated through urine buildup in your blood and body if the glomeruli are unable to adequately filter fluids.
Diabetic Kidney Disease Symptoms
Diabetic kidney disease shows no symptoms in its early stages, which is a problem since early treatment is the best method to deal with the issue! These are the most common symptoms that people start to experience when the kidney damage becomes considerable:
Nausea
Vomiting
Foamy urine
Exhaustion
Muscle cramps
Shortness of breath
Appetite loss
Trouble concentrating
Itchy, dry skin
Treatment Options for Diabetic Kidney Disease
Diabetic kidney disease can be managed or avoided with early intervention, and maintaining and controlling blood pressure and blood glucose levels is the primary goal of therapy. The best treatments for diabetic kidney disease include medication and dietary changes.
1. Medication
The following medications may be part of your treatment if you have diabetic kidney disease in its early stages:
Blood sugar level
In patients with diabetic kidney disease, medications can assist in managing elevated blood sugar levels, and diabetic medications like insulin are often prescribed. However, SGLT2 inhibitors, glucagon-like peptide 1 (GLP-1) receptor agonists, and metformin are examples of more recent medications used for treatment. Find out from your doctor if you could benefit from therapies like GLP-1 receptor agonists or SGLT2 inhibitors, as these therapies can prevent diabetes-related damage to the kidneys and heart.
Blood pressure
High blood pressure is treated using medications known as angiotensin-converting enzyme (ACE) inhibitors and angiotensin 2 receptor blockers (ARBs) in people with diabetic kidney disease.
Kidney scarring
In diabetic kidney disease, finer enone may lessen tissue scarring, and the medication may reduce the chance of renal failure as well, according to research. In individuals with chronic renal disease associated with type 2 diabetes, it may also reduce the incidence of heart attacks and hospitalization for heart failure.
High cholesterol
Statins are cholesterol-lowering medications that are used in treating excessive cholesterol, and they also reduce urine protein levels in patients with diabetic kidney disease.
2. Dietary changes
Dietary changes are another management of diabetic kidney disease method that works well in the early stages of the disease. Be careful about drinking too much water or digesting food with the following components, as they can make the situation worse.
Water - While necessary, consuming excessive amounts of water or fluids might raise the risk of blood pressure and edema.
Protein - Protein can lead to waste accumulation in the blood, which puts additional strain on the kidneys in people with renal disease.
Phosphorus - This component is found in a lot of dairy and protein meals, but an excess of phosphorus can strain the kidneys and damage bones.
Potassium - Higher potassium levels in people with renal disease can have an impact on their nerve cells.
Sodium - A component of salt; too much sodium can cause an increase in blood pressure.
3. Dialysis and Kidney Transplant
Dialysis or a kidney transplant is required if diabetic kidney disease develops into end-stage renal disease (ESRD). For patients with ESRD, dialysis is often required for the remainder of their lives or until a kidney transplant becomes available.
How to Prevent Diabetic Kidney Disease?
These are the methods doctors recommend to prevent diabetic kidney disease:
Treat your diabetes - You may maintain your blood sugar levels close to the desired range if your diabetes is properly treated, and diabetic kidney disease may be avoided or slowed down by this.
Manage high blood pressure - Work with your healthcare provider to manage any diseases that increase your risk of kidney disease, such as high blood pressure.
Weight control - Being physically active can help you maintain your healthy weight, which helps all the organs of your body.
Avoid smoking - Smoking cigarettes can harm the kidneys or exacerbate existing damage, so if you smoke, discuss with your doctor what can help you quit smoking.
Use over-the-counter medications carefully - Aspirin and nonsteroidal anti-inflammatory medications like ibuprofen and naproxen sodium can cause kidney damage if taken too frequently.
How Is Diabetic Kidney Disease Diagnosed?
Diagnosing diabetic kidney disease often occurs during routine testing as part of diabetes management, so if you have had diabetes for more than five years, your doctor will recommend these tests.
Urinary albumin test | This test can identify albumin, a blood protein, in urine, and if there is an excessive amount of albumin in your urine, your kidneys are not functioning properly. |
Albumin/creatinine ratio | Healthy kidneys remove the chemical waste product creatinine from the blood, and a urine sample's albumin/creatinine ratio indicates the kidneys' level of function. |
Glomerular filtration rate (GFR) | A blood sample's creatinine level can be used to gauge how rapidly the kidneys filter blood. The glomerular filtration rate is the term for this, and a low rate indicates poor kidney function. |
Kidney biopsy | This process involves obtaining kidney tissue samples for laboratory analysis. You will need a local anesthetic, and then the kidney tissues are extracted with a tiny needle. |
Final Remarks
If you have diabetes for a long period, chances are the high blood sugar content of your blood has affected your kidneys. You cannot undo kidney damage if you have diabetic kidney disease. However, the progression of the disease can be slowed down or even stopped with an early diagnosis and adherence to your treatment plan monitored by your doctor.
If you or someone you know is suffering from kidney problems, visit your nearest super-specialty hospital as soon as possible!
FAQs
1. Can diabetic kidney disease be reversed?
While DKD cannot usually be reversed, early detection and proper management can slow its progression and reduce complications.
2. How often should I get tested for diabetic kidney disease?
People with diabetes should have an annual urine albumin test and eGFR (estimated glomerular filtration rate) test to monitor kidney health.
3. Does diabetic kidney disease lead to kidney failure?
If left untreated, DKD can progress to end-stage renal disease (ESRD), requiring dialysis or a kidney transplant. Early intervention can significantly lower this risk.
4. Can diet help manage diabetic kidney disease?
Yes, a kidney-friendly diet low in sodium, protein, and phosphorus can help reduce strain on the kidneys and slow disease progression. Consulting a dietitian is recommended.
5. Are there any lifestyle changes to help manage DKD?
Lifestyle changes such as regular exercise, stress management, avoiding smoking, and maintaining a healthy weight are crucial in managing DKD.
Citations
Di Lullo, L., Lavalle, C., Scatena, A., Mariani, M., Ronco, C., & Bellasi, A. (2023). Finerenone: Questions and Answers—The four Fundamental Arguments on the New-Born Promising Non-Steroidal Mineralocorticoid Receptor Antagonist. Journal of Clinical Medicine, 12(12), 3992. https://doi.org/10.3390/jcm12123992
Diabetic kidney disease. (2024, December 13). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease
Drożdżal, S., Lechowicz, K., Szostak, B., Rosik, J., Kotfis, K., Machoy‐Mokrzyńska, A., Białecka, M., Ciechanowski, K., & Gawrońska‐Szklarz, B. (2021). Kidney damage from nonsteroidal anti‐inflammatory drugs—Myth or truth? Review of selected literature. Pharmacology Research & Perspectives, 9(4). https://doi.org/10.1002/prp2.817
Fu, Y., Xu, Z., Zhao, M., & Xu, K. (2022). The association between smoking and renal function in people over 20 years old. Frontiers in Medicine, 9. https://doi.org/10.3389/fmed.2022.870278
Gerich, J. E. (2009). Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications. Diabetic Medicine, 27(2), 136–142. https://doi.org/10.1111/j.1464-5491.2009.02894.x
Ghaderian, S. B., Hayati, F., Shayanpour, S., & Mousavi, S. S. B. (2015). Diabetes and end-stage renal disease; a review article on new concepts. PubMed, 4(2), 28–33. https://doi.org/10.12861/jrip.2015.07
Grillo, A., Salvi, L., Coruzzi, P., Salvi, P., & Parati, G. (2019). Sodium intake and hypertension. Nutrients, 11(9), 1970. https://doi.org/10.3390/nu11091970
Jormeus, A., Karlsson, S., Dahlgren, C., Lindström, T., & Nystrom, F. H. (2010). Doubling of water intake increases daytime blood pressure and reduces vertigo in healthy subjects. Clinical and Experimental Hypertension, 32(7), 439–443. https://doi.org/10.3109/10641961003686450
Ko, G., Rhee, C. M., Kalantar-Zadeh, K., & Joshi, S. (2020). The effects of High-Protein diets on kidney health and longevity. Journal of the American Society of Nephrology, 31(8), 1667–1679. https://doi.org/10.1681/asn.2020010028
Sarnowski, A., Gama, R. M., Dawson, A., Mason, H., & Banerjee, D. (2022). Hyperkalemia in chronic kidney disease: links, risks and management. International Journal of Nephrology and Renovascular Disease, Volume 15, 215–228. https://doi.org/10.2147/ijnrd.s326464
Uribarri, J., & Calvo, M. S. (2013). Dietary phosphorus excess: a risk factor in chronic bone, kidney, and cardiovascular disease? Advances in Nutrition, 4(5), 542–544. https://doi.org/10.3945/an.113.004234
Varma, P. P. (2015, June 1). Prevalence of chronic kidney disease in India - Where are we heading? https://pmc.ncbi.nlm.nih.gov/articles/PMC4446915/
What is Kidney Failure? (2022, December 18). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/what-is-kidney-failure
Your Kidneys & How They Work. (2025, January 9). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work#:~:text=Each%20of%20your%20kidneys%20is,your%20blood%20and%20removes%20wastes.
