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Kidney Failure and Diabetes

Controlling blood sugar, blood pressure and cholesterol may slow the progression of kidney disease.

Chronic kidney disease is a condition in which the kidneys are damaged and cannot filter blood well. This damage can cause wastes to build up in the body and leads to other health problems, including heart disease, anemia, and bone disease. Chronic kidney disease eventually can cause kidney failure if it is not treated.

Adults with diabetes or high blood pressure are at an increased risk of chronic kidney disease. Other risk factors include heart disease, obesity, older age, high cholesterol, and a family history of chronic kidney disease.

More than 35% of adults with diabetes have chronic kidney disease. Poorly controlled diabetes and high blood pressure increase the risk that chronic kidney disease will eventually lead to kidney failure, which can only be treated by dialysis or a kidney transplant.

Improving control of blood sugar, blood pressure and cholesterol may slow the progression of kidney disease. Among people with diagnosed diabetes, the age-adjusted incidence rate of kidney failure declined by 35% between 1996 and 2007. While the rate of people with diabetes who developed a new case of kidney failure declined, the number of people with diabetes who experienced kidney failure increased by about half. This apparent paradox is due to the dramatic rise in the number of people with diabetes between 1996 and 2007. Thus, the rate of people with diabetes who developed a new case of kidney failure was measured among a group of people that steadily grew larger. 

It’s important to keep reducing risk factors for kidney failure and to improve diabetes care. The decline in kidney failure rates among people with diabetes may come from lowering risk factors for kidney failure, such as high blood glucose (sugar) and high blood pressure, or from better treatment of kidney disease, including new medications that slow the disease and delay kidney failure.

It’s unusual to feel any symptoms in the early stages of chronic kidney disease. Blood and urine tests are the only ways to tell if you have the disease. Getting diagnosed early is important, because early treatment can slow down the disease, and prevent or delay kidney failure. Treatment includes medications such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) that lower blood pressure and slow the decline in kidney function.

Other steps to help keep your kidneys healthy include the following:

• Meeting your blood glucose (sugar) targets as often as you can
• Keeping blood pressure below 130/80 mm/hg
• Staying in your target cholesterol range
• Eating less salt and salt substitutes
• Eating healthy foods
• Staying physically active
• Taking your medications as prescribed