Focus on diabetes and kidney disease

Diabetes is a leading cause of chronic kidney disease (CKD), but if you do develop kidney damage because of diabetes, treatment can help to stop it getting worse.

Nearly one in five people with diabetes will need to be treated for CKD. That may sound quite scary but the good news is there’s a lot you and your healthcare team can do to help lower your risk.

What is diabetes?

When you have diabetes, the levels of glucose (sugar) in your blood are too high.

Glucose comes from the things you eat and drink and normally it’s moved from your bloodstream to your body’s cells by the hormone insulin, made in your pancreas. But in diabetes, this process doesn’t happen properly. There are two main types of diabetes:

  1. Type 1 diabetes usually starts when you’re a child or teenager. You can’t make insulin yourself because your body mistakenly attacks the cells in the pancreas that make it, so you need to take insulin instead.
  2. Type 2 diabetes develops when you’re older. This normally means in middle age and beyond, although it is now being seen more in younger people. You make some insulin but usually not enough, and your body doesn’t use it properly.

How does diabetes cause CKD?

When blood glucose is high over a long period of time, it causes extra blood to flow through your kidneys’ tiny filters. That means they have to work harder to clean the blood. Eventually, this process can damage the filters and make them leak. This damage means the kidneys can’t do their jobs so well.

Having diabetes doesn’t mean you’ll definitely develop CKD. In fact, it’s hard for doctors to know how many people end up with CKD just because of their diabetes. That’s because people with diabetes often have other conditions and risk factors also linked with CKD. Research does show type 2 diabetes puts you at higher risk than type 1 diabetes, probably because people with type 1 tend to be younger and otherwise healthier than people with type 2.

Here are some of the other things that raise your risk of CKD when you have diabetes.

  • High blood pressure. Lots of people with diabetes also develop high blood pressure, which is another leading cause of CKD. High blood pressure causes the artery to your kidneys to fur up, reducing its blood supply and causing damage. And the three conditions – diabetes, CKD and high blood pressure – can all feed into each other. CKD and diabetes can both raise your blood pressure, increasing your risk of heart attacks and strokes.
  • Heart disease. It’s common to have heart disease alongside diabetes and it can put further strain on your kidneys. Again, it’s a two-way relationship. As your kidneys struggle to get rid of waste and fluid, your heart and blood vessels come under more pressure.
  • Ethnicity – people from certain groups are more likely to develop CKD with diabetes, including Black and South Asian people.
  • A family history of kidney disease.
  • Certain lifestyle factors, including smoking, a diet high in salty foods, being overweight and not getting enough exercise.

Monitoring diabetes and your kidney health

One of the most important things you can do to keep your kidneys healthy is stay on top of your diabetes.

If you’re having trouble managing your blood glucose and blood pressure, you need to get more support from your healthcare team.

It’s also really important you go to your regular appointments so your healthcare team can monitor your kidney health as well as your diabetes. Picking up early signs of kidney damage means you can have treatment to help prevent it getting worse.

Your healthcare team should:

  • test your wee for protein, an early sign of kidney disease
  • test your blood creatinine to find out how well your kidneys are working
  • help you manage your blood glucose to reduce the risk of kidney damage.

How to keep your kidneys healthy if you have diabetes

There are lots of simple steps you can take to protect your kidneys when you have diabetes. Your healthcare team can advise you on what’s best for you but these are some of the most important things you can do to protect your kidneys.

  • Don’t smoke. It can make kidney disease worse and raise your risk of heart disease. Talk to your GP, nurse or pharmacist about getting help to quit.
  • Manage your blood pressure. It should be 130/80 or lower. It’s a good idea to get hold of a blood pressure monitor you can use at home to help you keep an eye on it. Your doctor can prescribe medicine to lower blood pressure if necessary.
  • Keep your cholesterol level within the range your healthcare team recommend. Diet and medication can both help with this so talk to your doctor or nurse about the best ways to manage your cholesterol.
  • Stay active and have a healthy, balanced diet.
  • Lose weight if you need to – speak to your healthcare team about the best way to do this.
  • Don’t drink more than 14 units of alcohol each week.

AstraZeneca has contributed to the funding of this material as part of a Patient Advocacy Group Partnership between Kidney Care UK and AstraZeneca UK Limited. AstraZeneca has had no editorial input into or control over the content which has been independently owned and created by Kidney Care UK.

Diabetes finger prick test