How can I prevent kidney disease if I have diabetes?

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There is much that a person with diabetes can do to prevent kidney disease or slow the progression once it begins. The basics of diabetes and blood pressure control that protect against all complications also apply to the kidneys. Keep body weight in check to avoid obesity. If you are overweight or obese, increase activity and decrease caloric intake. Modify your lifestyle to make this a way of life, not a diet. Also, control your blood pressure, cholesterol and triglycerides with medications, if necessary, and don’t smoke.  
 

Most people with diabetes will eventually experience some degree of damage to their kidneys, but you can help prevent further damage, or kidney failure, by managing your blood sugar and blood pressure. A yearly urine check for signs of kidney disease can detect problems early, so if you have diabetes and haven't had a urine test, ask your doctor about it. If protein is found in your urine, your doctor may prescribe medication to slow kidney disease.

Several things can help you prevent or delay kidney disease if you have diabetes. If you already have kidney disease, these steps also help slow it down. All of these strategies work best if you start them at the earliest stages of kidney disease.

Keeping your blood pressure on target helps you avoid kidney disease, heart and blood vessel problems, and diabetic eye disease. The American Diabetes Association (ADA) recommends that most people aim for a blood pressure level of less than 130 over 80. There are many types of medications to control blood pressure but one type in particular, called an ACE inhibitor, has been proven to slow the progression of kidney disease. In fact, it's so effective that doctors even prescribe it for people who don't have high blood pressure so that they can protect their kidneys. Another type of medication, called an ARB, also can help protect kidney function. You may need several types of blood pressure medications to reach your goal.

Another important thing you can do is to reach your blood glucose targets as often as possible. Talk with your health care team about the best blood glucose targets for you. The ADA recommends the following targets:
 
  • When you wake up and before meals: 70 to 130 mg/dl
  • 2 hours after starting a meal: below 180 mg/dl

You'll also want to have an A1C test (also reported as estimated average glucose or eAG) at least twice a year. The results provide your average glucose levels for the previous 2 to 3 months. The ADA suggests that most people aim for an A1C of less than 7% or if reported as eAG less than 154 mg/dl.

Making sure you get regular checkups, including an annual check of your urine for microalbumin (small amounts of protein), will ensure that you're keeping up with your diabetes care. In addition, a weight loss of even 10 or 15 pounds can help you reach your blood glucose and blood pressure targets.

Continue Learning about Diabetes Complications

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.