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A guide to the kidneys for people with diabetes

More than 30 percent of adults with diabetes will develop kidney disease. Here’s your guide to these important organs.

Diabetes can damage the kidneys and cause the kidneys to stop working correctly.

Updated on November 12, 2024

The kidneys are a pair of organs located on either side of the spine, just below the rib cage. They remove waste and excess fluid from the blood, so it can be expelled in urine. They also help regulate blood pressure and make a hormone that the body needs to produce red blood cells. This makes the kidneys two of the most important organs in the body.

Diabetes is a chronic condition where the body cannot make enough insulin or effectively use the insulin it does make. Insulin is a hormone the body requires in order to use blood sugar (glucose), one of its primary sources of energy.

Diabetes can damage the kidneys and cause them to stop working correctly. While not everyone with diabetes will end up with kidney disease, the risk is certainly higher. Roughly 1 in 3 people with diabetes also have kidney disease.

Below are some key terms and phrases to help you understand the kidneys. Knowing them can be helpful when you're learning how type 2 diabetes can affect the health of the kidneys.

Albumin: A protein made by the liver that helps carry nutrients throughout your body, maintain fluid levels, and keep you healthy

Albumin/creatinine ratio: A method of detecting elevated protein levels

Chronic kidney disease (CKD): Occurs when your kidneys are damaged to the point where they can no longer filter blood properly

Creatinine: Waste created by your muscles and filtered by your kidneys

Diabetic kidney disease: A type of chronic kidney disease that’s caused by diabetes

Dialysis: A procedure to remove waste from the body when the kidneys no longer function properly

End-stage renal disease (ESRD): The last stage of kidney disease in which your kidneys stop working, usually requiring long-term dialysis or a kidney transplant

Erythropoietin: A hormone produced by the kidneys that helps make red blood cells

Glomerular filtration rate (GFR): A blood test to see how well your kidneys are working

Glomeruli: Blood vessels in the kidneys that filter blood to create urine

Hypertension: A condition marked by increased resistance to blood flow in the arteries. As a consequence, your heart has to pump harder to circulate blood, which results in high blood pressure or hypertension. People with diabetes are more likely to have high blood pressure.

Kidney failure: Another term for ESRD

Nephrons: The filtering units that make up the structure of the kidneys

Nephropathy: Deterioration of the kidneys and kidney function due to kidney disease, often caused by hypertension in people with diabetes

Renal: A term that refers to the kidneys

Renal failure: Another term for kidney failure

Urine albumin test: When the kidneys stop working properly, proteins can leak from your kidneys into your urine. This test looks for albumin (blood protein) in your urine to detect signs of kidney damage.

Vitamin D: A hormone created in the kidneys that helps the body absorb calcium and phosphorus, both of which are important to bone health

If you have diabetes, it is important to work closely with a healthcare provider (HCP). Taking steps like controlling your blood sugar levels—as well as monitoring your blood pressure and cholesterol—can help keep your kidneys as healthy as possible. These steps can also reduce other complications, such as cardiovascular problems.

Remember that your HCP will be your best source of information for treating diabetes and kidney problems. Talk to your HCP about your treatment options. There are several medications for people who have diabetes that can help protect the health of the kidneys and the heart.

Article sources open article sources

National Kidney Foundation. How Your Kidneys Work. Accessed November 12, 2024.
National Institute of Diabetes and Digestive and Kidney Diseases. What Is Diabetes? April 2023.
Centers for Disease Control and Prevention. Diabetes Basics. May 15, 2024.
National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic Kidney Disease. February 2017.
National Kidney Foundation. Diabetes and Chronic Kidney Disease. January 2016.
Centers for Disease Control and Prevention. Diabetes and Chronic Kidney Disease. May 15, 2024.
National Institute of Diabetes and Digestive and Kidney Diseases. Chronic Kidney Disease (CKD). October 2016.
Johns Hopkins Medicine. Diabetic Nephropathy (Kidney Disease). Accessed November 12, 2024.
National Institute of Diabetes and Digestive and Kidney Diseases. Your Kidneys & How They Work. June 2018.
Harvard T.H. Chan School of Public Health. Vitamin D. March 2023.
Cleveland Clinic. Erythropoietin-Stimulating Agents/Erythropoietin. November 10, 2022.
Johns Hopkins Medicine. Diabetes and High Blood Pressure. Accessed November 12, 2024.
NHS. Dialysis. September 29, 2021.
Fresenius Kidney Care. Nutrition Basics: What Is Albumin? Accessed November 12, 2024.
Mayo Clinic. Microalbumin test.
MedlinePlus. Creatinine Test. December 5, 2023.
National Kidney Foundation. ACR. Accessed November 12, 2024.
MedlinePlus. Glomerular Filtration Rate (GFR) Test. July 6, 2023.
Johns Hopkins Health. End Stage Renal Disease (ESRD). Accessed November 12, 2024.
American Kidney Foundation. Kidney failure, end-stage kidney disease (ESKD) or end-stage renal disease (ESRD). September 5, 2023.
National Institute of Diabetes and Digestive and Kidney Diseases. High Blood Pressure & Kidney Disease. March 2020.
National Kidney Foundation. High Cholesterol = High Kidney Disease Risk. Accessed November 12, 2024.
National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes, Heart Disease, & Stroke. April 2021.
American Heart Association. Newer Type 2 diabetes medications have heart and kidney disease benefits, too. September 28, 2020.
Mayo Clinic. Diabetic nephropathy (kidney disease). October 24, 2023.

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