Kidney disease caused by diabetes: your questions answered

About 7% of the UK population has diabetes and also at risk of developing kidney problems. Damage to the kidneys happens over time and is called chronic kidney disease (CKD) or diabetic kidney disease.

Around a quarter of people with diabetes get some kind of kidney damage,” says Professor Jeremy Levy, Consultant Nephrologist, Imperial College Healthcare NHS Trust.

One of the jobs of your kidneys is to remove waste products and excess fluid from your body. If you develop chronic kidney disease (CKD), it means that your kidneys are not doing their job as well as they should.

Why does diabetes cause CKD?

If you have diabetes, your blood sugar (or glucose) level is too high. This is because your body has problems producing the hormone insulin or your body’s cells don’t respond properly to insulin (insulin resistance). Your blood sugar levels can rise if your body can’t use the insulin as it should.

Over time, this high blood sugar can damage blood vessels and tiny filters in your kidneys. That is what leads to kidney disease.

Having type 1 or type 2 diabetes doesn’t guarantee that you’ll develop CKD, but it does increase your risk.

How can I look after my kidney health if I have diabetes?

If you have diabetes, some of the things you can do to keep your kidneys as healthy as possible include:

● Controlling your blood sugar

● Keeping your blood pressure low

● Stopping smoking (if you smoke)

● Keeping as active as possible

● Losing weight (if you need to)

● Asking your GP if you would suit medication

● Going to all your medical appointments

Find out more about these ways to look after your kidney health if you have diabetes.

“Some of the lifestyle changes we encourage for people with diabetes and CKD can seem challenging and overwhelming at first,” says Collette Kelly, Diabetes Specialist Nurse, Liverpool Diabetes Partnership.

“Our advice is to start by taking small steps towards a healthier lifestyle. If you can keep taking these small steps, they add up to longer-term changes.”

My nurse/GP says I have prediabetes. Does this mean I have CKD too?

Prediabetes is the stage before diabetes. It means your blood sugar levels are higher than normal, but not high enough to have type 2 diabetes. You won’t have developed any kidney damage yet but could in the future if you’re diagnosed with diabetes.

“If you have a family history of diabetes, are getting overweight and your blood sugars are running slightly high, you’ll be encouraged to exercise more and change your diet so you lose weight,” says Professor Levy.

“But if you carry on the same, over the next five to 10 years you’ll become diabetic and will have a risk of kidney damage later on.”

If I have diabetes will I have tests for CKD?

As part of your diabetes care, your GP should offer you tests for kidney disease every year. This is so they can spot any problems early. These tests include:

● a blood test to check your kidney function

● a urine test to check your urine (wee) for protein

“Most diabetics with kidney damage are managed well by their GP as part of their diabetes care,” says Professor Levy. “Your GP may only refer you to a specialist kidney clinic in a hospital if you’ve lost substantial kidney function or have large amounts of protein in your urine.”

Read our advice about how to talk to your GP or practice nurse about your risk of kidney damage with diabetes.

Are there signs of diabetic kidney damage I should look out for?

If your diabetes damages your kidneys, it’ll happen slowly and over time. In the early stages of kidney disease, there might not be any symptoms you notice. That’s why it’s important to go to your yearly diabetes and kidney checks.

As your kidney function gets worse, you could notice symptoms like:

● tiredness

● swollen ankles, feet and hands

● breathlessness

● feeling sick

● loss of appetite

● needing to wee more often at night

● itching skin

● cramps in your legs at night

If I have chronic kidney disease, can I reverse it?

No, but you can prevent your kidney damage from getting worse. If you can, try to make lifestyle changes when you’re first diagnosed with CKD.

“Think about what happens when you drain rice through a sieve,” says Collette Kelly. “A sieve that works properly keeps all the rice in while it lets all the water out. That’s what healthy kidneys do.

“But if the sieve starts getting little holes, some rice leaks out with the water. That’s like protein leaking out into your urine when your kidneys have started to become damaged.

“Over time, that sieve will have more holes in it and will leak even more rice. That’s like your kidneys leaking even more protein into your urine as your kidney damage gets worse.”

If my kidneys stop working, what will my options be?

If your kidneys eventually become so damaged that they can’t do their job well enough anymore, that means you’re at end stage kidney disease, or kidney failure.

Chronic kidney disease is common but it is rare for it to result in kidney failure.

There two treatment options for kidney failure: dialysis or a kidney transplant.

Dialysis is a type of treatment that takes over some of your kidneys’ job by removing waste products and excess fluid from your blood.

There are two types of dialysis:

  1. Haemodialysis, which you go to a hospital or clinic to have, or have at home
  2. Peritoneal dialysis, which is done at home with the support of your healthcare team

A kidney transplant may be another option. This is an operation where a healthy (or healthier) kidney is put into your body from someone else’s body. Your kidney donor can be a living donor, like a relative or a friend, or a deceased donor (someone who has died).

This patient information resource has been made possible with a financial contribution from Bayer. Bayer has had no editorial input into or control over the content which has been independently owned and created by Kidney Care UK.