Prevent diabetes problems: Keep your kidneys healthy - ...

Prevent diabetes problems: Keep your kidneys healthy

Prevent diabetes problems: Keep your kidneys healthy
NDIC

What are diabetes problems?

Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.

Drawing of an image of the human form with the kidneys, ureters, and bladder labeled.
Your kidneys are two bean-shaped organs about the size of your fist. They are located just below the rib cage, near your back.

This information is about kidney problems caused by diabetes. You will learn the things you can do each Kidneys day and during each year to stay healthy and prevent diabetes problems.

What should I do each day to stay healthy with diabetes?
Drawing of a bowl containing bananas, grapes, and an apple. Follow the healthy eating plan that you and your doctor or dietitian have worked out.
Drawing of a silhouette of a woman who is walking. Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
Drawing of an open pill container on its side with some pills spilling out and an insulin bottle. Take your medicines as directed.
Drawing of hand holding a blood glucose meter that reads 114. Check your blood glucose every day. Each time you check your blood glucose, write the number in your record book.
Drawing of two hands holding a bare foot. Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.
Drawing of a toothbrush and a container of floss with some floss hanging out. Brush and floss your teeth every day.
Drawing of two arms and a blood pressure cuff is around one arm. Control your blood pressure and cholesterol.
Drawing of a lit cigarette in a circle covered by a slash sign to show that smoking is not allowed. DonÌt smoke.

What do my kidneys do?

The kidneys act as filters to clean the blood. They get rid of wastes and send along filtered fluid. The tiny filters in the kidneys are called glomeruli.

Drawing of a cross section of a kidney with parts and functions labeled.
You have two kidneys. Your kidneys clean your blood and make urine. This drawing shows a cross section of a kidney.

When kidneys are healthy, the artery brings blood and wastes from the bloodstream into the kidneys. The glomeruli clean the blood. Then wastes and extra fluid go out into the urine through the ureter. Clean blood leaves the kidneys and goes back into the bloodstream through the vein.

How can I prevent diabetes kidney problems?

* Keep your blood glucose as close to normal as you can. Ask your doctor what blood glucose numbers are healthy for you.
* Keep your blood pressure below 130/80 to help prevent kidney damage. Blood pressure is written with two numbers separated by a slash. For example, 120/70 is said as Ï120 over 70.Ó

Ask your doctor what numbers are best for you. If you take blood pressure pills every day, take them as your doctor tells you. Keeping your blood pressure under control will also slow down or prevent damage to your eyes, heart, and blood vessels.

Drawing of a doctor checking a patientÌs blood pressure with a blood pressure cuff.
Keep your blood pressure below 130/80.
* Ask your doctor if you should take pills to slow down kidney damage. Two kinds are available:
o ACE (angiotensin converting enzyme) inhibitor
o ARB (angiotensin receptor blocker)

* Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein, such as meat.
* Have your kidneys checked at least once a year by having your urine tested for small amounts of protein. This test is called the microalbumin test.
* Have your blood tested at least once a year for creatinine. The result of this test should be used to estimate your glomerular filtration rate (GFR), a measure of kidney function.

Drawing of two closed pill containers and one open pill container on its side with some pills spilling out.Pills can help you control your blood pressure and slow down kidney damage.
* Have any other kidney tests your doctor thinks you need.
* Avoid taking painkillers regularly. Daily use of pills like aspirin or acetaminophen can damage the kidneys. Taking a single dose of aspirin every day to protect the heart, however, should be safe. Taking acetaminophen for occasional pain should also be safe. But if you are dealing with chronic pain, such as arthritis, work with your doctor to find a way to control your pain without putting your kidneys at risk.
* See a doctor right away for bladder or kidney infections. You may have an infection if you have these symptoms:
o pain or burning when you urinate
o a frequent urge to go to the bathroom
o urine that looks cloudy or reddish
o fever or a shaky feeling
o pain in your back or on your side below the ribs

How can my doctor protect my kidneys during special x-ray tests?

X-ray tests using a contrast agent pose a risk to your kidneys. If you need x rays, your doctor can give you extra water before and after the x rays to protect your kidneys. Or your doctor may decide to order a test that does not use a contrast agent.

How can diabetes hurt my kidneys?

When the kidneys are working well, the tiny filters in your kidneys, the glomeruli, keep protein inside your body. You need the protein to stay healthy.

High blood glucose and high blood pressure damage the kidneysÌ filters. When the kidneys are damaged, the protein leaks out of the kidneys into the urine. Damaged kidneys do not do a good job of cleaning out wastes and extra fluid. Wastes and fluid build up in your blood instead of leaving the body in urine.

Drawing of a kidney cross section, with parts and functions labeled, showing a healthy kidney.Drawing of a kidney cross section, with parts and functions labeled, showing an unhealthy kidney.
No protein is leaking from the healthy kidney. Protein is leaking from the unhealthy kidney.

Kidney damage begins long before you notice any symptoms. An early sign of kidney damage is when your kidneys leak small amounts of a protein called albumin into the urine. But the only way to know about this leakage is to have your urine tested.

With more damage, the kidneys leak more and more protein. This problem is called proteinuria. More and more wastes build up in the blood. This damage gets worse until the kidneys fail.

Diabetic nephropathy is the medical term for kidney problems caused by diabetes. Nephropathy affects both kidneys at the same time.

What can I do if I have kidney problems caused by diabetes?

Once you have kidney damage, you cannot undo it. But you can slow it down or stop it from getting worse by controlling your blood pressure, taking your ACE inhibitors or ARBs, and having your kidney function tested regularly. However, if you are pregnant, you should not take ACE inhibitors or ARBs.

Drawing of a man sitting at a table and checking his blood pressure.
Keeping blood pressure under control helps to keep your kidneys healthy.

How will I know if my kidneys fail?

At first, you cannot tell. Kidney damage from diabetes happens so slowly that you may not feel sick at all for many years. You will not feel sick even when your kidneys do only half the job of normal kidneys. You may not feel any signs of kidney failure until your kidneys have almost stopped working. However, getting your urine and blood checked every year can tell you how well your kidneys are working.

Once your kidneys fail, you may feel sick to your stomach and tired all the time. Your hands and feet may swell from extra fluid in your body.

Drawing of a distressed woman who is slightly bent over and clutching her stomach.
You may feel sick to your stomach when your kidneys stop working.

What happens if my kidneys fail?

One way to treat kidney failure is with dialysis. Dialysis is a treatment that does some of the work your kidneys used to do. Two types of dialysis are available. You and your doctor will decide what type will work best for you.

Drawing of a woman undergoing dialysis. She sits in a chair and is hooked up to the dialysis machine.
Dialysis is a treatment that takes waste products and extra fluid out of your body.

1. Hemodialysis. In hemodialysis, your blood flows through a tube from your arm to a machine that filters out the waste products and extra fluid. The clean blood flows back to your arm.
2. Peritoneal dialysis. In peritoneal dialysis, your belly is filled with a special fluid. The fluid collects waste products and extra water from your blood. Then the fluid is drained from your belly and thrown away.

Another way to treat kidney failure is to have a kidney transplant. This operation gives you a new kidney. The kidney can be from a close family member, friend, or someone you do not know. You may be on dialysis for a long time. Many people are waiting for a new kidney. A new kidney must be a good match for your body.

Will I know if I start to have kidney problems?

No. You will know you have kidney problems only if your doctor checks your blood for creatinine and your urine for protein. Do not wait for signs of kidney damage to have your blood and urine checked.

How can I find out if I have kidney problems?

Two lab tests can tell you and your doctor how well your kidneys are working.

* Each year, make sure your doctor checks a sample of your urine to see if your kidneys are leaking small amounts of protein called microalbumin.
* At least once each year, your doctor should check your blood to measure the amount of creatinine. Creatinine is a waste product your body makes. If your kidneys are not cleaning waste products from your blood, they can build up and make you sick. Your doctor can use your creatinine level to check your GFR. GFR stands for glomerular filtration rate. Results of this test tell you how well your kidneys are removing wastes from the blood.