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- Diabetes is one of the leading causes of kidney failure in the U.S.
- Oftentimes, chronic kidney disease (CKD) doesn’t have any symptoms, so it’s possible to be completely unaware that your kidney health is in jeopardy if you’re not checking your kidneys with blood or urine tests.
- Preventing chronic kidney disease while living with diabetes is largely a matter of successfully managing the latter.
Living with diabetes often means managing certain aspects of your health to prevent not just diabetes-related complications, but also health issues that are commonly associated with the chronic condition—such as chronic kidney disease (CKD). But what exactly is CKD and what is the connection between kidney disease and diabetes?
What Is Chronic Kidney Disease?
Reminder: Your kidneys are a vital organ in your body. They filter your blood to remove waste and extra fluid to help keep you alive.
When you live with chronic kidney disease, however, that means you’re experiencing a gradual loss of kidney function, and waste is building up inside your body throughout that time. Plus, your kidneys make certain hormones that help your body manage your blood pressure, so poor kidney health, when left unmanaged, can also lead to heart health issues.
Over time, kidney disease can lead to kidney failure, in which case you’d need dialysis or a kidney transplant to manage your health. Unfortunately, though, it’s possible to experience kidney damage with no symptoms, meaning your only way of knowing something’s off is to get your kidneys checked with blood and urine tests.
But, the sooner you know you have kidney disease, the sooner you can do something about it.
The Link Between Diabetes and Kidney Disease
According to the Centers for Disease Control and Prevention (CDC), diabetes is one of the leading causes of kidney failure in the U.S.
Why? “High blood sugar can damage your blood vessels, which can impact the kidneys in two ways,” explains One Drop coach, Danica Crouse, a registered dietitian/nutritionist (RDN) and certified nutrition support clinician (CNSC). “First, damaged blood vessels in the kidneys can impair how well the kidneys filter your blood, and secondly, high blood sugar can cause blood vessels throughout your body to stiffen, which can lead to hypertension. High blood pressure can then accelerate the damage of blood vessels in the kidneys and make it harder for those cells to receive the oxygen and nutrients they need to do their job.”
So, if you live with diabetes, what exactly are your odds of developing CKD? The CDC estimates that one in three adults living with diabetes may have kidney disease, and research shows that about 30% of those living with type 1 diabetes and about 40% of those living with type 2 diabetes, respectively, may develop CKD at some point.
Preventing Kidney Disease While Living with Diabetes
Luckily, preventing CKD largely entails a lot of the same steps you probably already take to manage diabetes.
- Follow heart-healthy and blood sugar-friendly eating patterns. Considering the links between kidney health, blood sugar, and your heart, Crouse recommends eating foods that help you manage all of these aspects of your health. Think: more high-fiber foods like fruits, vegetables, whole grains, and legumes, and fewer saturated fats, sugary foods, and sodium-heavy meals. “Kidney disease can lead to cardiovascular disease, so it’s especially important to be mindful of sodium intake (aiming for 2,300 mg daily, or 1,500 mg daily if you already live with hypertension),” explains Crouse. She also suggests eating more plant-based foods, which can help lower your risk of CKD by helping to reduce insulin resistance, lower blood pressure, decrease the amount of protein lost in your urine, and reduce hyperfiltration (i.e. how hard the kidneys have to work to filter and remove waste).
- Keep an eye on your protein intake, too. “A common approach to managing blood sugar is to follow a low-carb, high-protein way of eating,” explains Crouse. “But eating excess protein has been associated with increased albuminuria (elevated protein in the urine, which may be a sign of kidney damage), more rapid kidney function loss, and cardiovascular disease mortality.” She suggests following the American Diabetes Association (ADA)’s recommendation for daily protein intake—1-1.5 grams/kg of body weight (15% to 20% of total daily calories) for healthy people living with diabetes—and only reducing to 0.8 grams/kg of body weight if you live with stage 3 (or higher) chronic kidney disease. Either way, be sure to limit red meat in your meals, and choose lean proteins such as tuna or chicken whenever you can; or, if you’re comfortable, make plant-based protein swaps for animal meat from time to time. (Need help with mapping out your meals? Your One Drop coach can introduce you to meal planners that address all your nutritional needs.)
- Stay active. Just as regular physical activity is important for diabetes management, it can also benefit your efforts toward CKD prevention, thanks to exercise’s ability to help improve blood pressure and insulin resistance, which we know factor into CKD risk as well. Crouse recommends following the ADA’s exercise guidelines, which call for at least 150 minutes of moderate-intensity activity (power walking, bike riding, water aerobics) per week.
- Prioritize your sleep schedule if you aren’t already. You might already know a thing or two about the link between blood sugar and sleep, but your sleep schedule also plays an important role in your kidney health, too. According to the National Kidney Foundation, kidney function is regulated by your body’s sleep-wake cycle. While we’re still learning about the mechanisms and hormones underlying the connection between the two, experts seem to agree that, when your sleep health is compromised, so is your kidney health. (Check out these expert-approved tips for better sleep.)
- Keep stress levels at a minimum. “Stress can impact many functions throughout the body, including blood sugar and blood pressure,” explains Crouse, which we know can affect kidney health as well. “It’s important to incorporate stress-reduction tools and coping strategies into your routine, such as yoga, meditation, and deep breathing.”
- Be careful about certain medications. On the one hand, some types of medication can actually help prevent CKD; for example, if you already live with hypertension (an important predictor for CKD), high blood pressure medicines such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin-2 receptor blockers (ARBs) may be effective in preventing kidney disease in people living with diabetes. However, when it comes to certain over-the-counter medications, such as non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen), Ndidiamaka Obadan, MD, a South Carolina-based doctor who’s board-certified in internal medicine, nephrology, and hypertension, cautions against daily or prolonged use, as it has been linked to CKD. Be sure to talk to your doctor about your NSAID use and how to find a dose that’s safe for you.
- Be a proactive advocate for your health. “Attend your regular doctor’s visits, talk to your doctor about your kidney health and your risks for CKD, and request annual screening if it isn’t already part of your routine labs,” suggests Crouse. “Don’t just know your numbers; talk about your results with your doctor and what they mean,” she adds, so you can feel confident about your ability to steer your health in the right direction when you leave your doctor’s office. (And, if you need someone in your corner to keep cheering you on when you lose motivation, your One Drop coach is always there for you.)
This article has been clinically reviewed by Danica Crouse, RDN, CNSC, clinical health coach at One Drop.