Extension Rural Health & Nutrition

Kidney Health and Diabetes

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Physical activity and adequate hydration are important to keeping the kidneys healthy. Image Credit: RHN Team Picture Bank

The kidneys are vital organs essential for survival, playing massive roles in waste management within the human body to support functions of all organ systems. To carry out their roles, the kidneys remove waste by filtering the blood and using the waste and extra fluids to produce urine. During this process, the kidneys remove acids to help maintain the blood’s balance of water, salts, and minerals. The kidneys also play a role in making hormones that control blood pressure, make red blood cells, and keep bones strong. If damage occurs to these organs, the body cannot function properly. Kidney damage, such as chronic kidney disease, is irreversible, and chronic kidney disease can be a life-altering complication of living with diabetes. Around 1 in 3 adults living with diabetes also live with chronic kidney disease. Therefore, people with diabetes should take necessary steps to manage blood sugar levels to protect the health of their kidneys.  

Understanding Chronic Kidney Disease 

Chronic kidney disease, or CKD, is a condition that usually progresses slowly over time. This diagnosis means that the kidneys are damaged and cannot filter blood as efficiently as they once did. CKD has 5 stages of classification, with stage 1 meaning very mild kidney damage and stage 5 meaning kidney failure. People with chronic kidney disease may not have symptoms in the early stages. However, as CKD progresses, symptoms can arise. Some of these symptoms can include: 

  • edema (swelling in the legs, feet, ankles, hands, and face) 
  • dry skin 
  • itching 
  • chest pain 
  • nausea and vomiting 
  • headaches  
  • weight loss, and 
  • feeling tired. 

These symptoms occur because the kidneys cannot properly filter waste from the blood. If you experience any of these symptoms, it is important to consult with a healthcare provider to determine the root cause. At stage 5 CKD, also referred to as end-stage kidney disease, a procedure known as dialysis is often needed to filter waste and extra fluid from the blood. If eligible, some people can become candidates to receive a kidney transplant. It is always important to consult a healthcare provider about what treatment options are available for the different stages of CKD.  

Determining Kidney Health 

Clinicians can order blood and urine tests to screen for kidney damage. Two laboratory tests using blood and urine samples aid clinicians in assessing kidney health. The blood test is called the estimated glomerular filtration rate (eGFR), and the urine test is called the urine albumin-creatinine ratio (UACR). The blood test measures the amount of creatinine in the blood, a waste product that should be removed by the kidneys when they are properly functioning. The urine test measures creatinine along with albumin. Albumin is an essential protein in the body that the kidneys stop from excreting into urine during proper blood filtration. Both of these tests are usually repeated before confirming a diagnosis of kidney disease. 

Actions to Help Prevent Chronic Kidney Disease 

Regular visits to healthcare providers are important to prevent and manage chronic kidney disease when living with diabetes. Those at risk should receive an annual kidney health screening to detect CKD as early as possible. There are several actions people can take to reduce their risk of CKD. 

Manage Blood Pressure – Unmanaged high blood pressure (hypertension) can damage the kidneys and alter their ability to filter blood properly. It is very important for people living with high blood pressure to properly manage their blood pressure. For more information on high blood pressure, check out HGIC 4367, Hypertension.  

Manage Blood Glucose (Sugar) Levels – People living with diabetes are at risk for developing CKD, especially if diabetes is unmanaged. This is because high blood glucose levels can injure the blood vessels in the kidneys over time and cause kidney damage. It is important to check blood glucose levels regularly. Talk with your healthcare provider about the best times and the best method for you to check your blood glucose. Talking with a healthcare professional to develop a diabetes self-management plan is important in managing blood glucose levels. To learn more about resources to help you manage your blood glucose, see HGIC 3889, Smartphone Apps for Diabetes Self-Management Support. 

Maintaining A Healthy Weight – Implementing regular physical activity and a healthy, balanced meal plan in your daily life can help with weight management while also decreasing the risk of chronic kidney disease. Choosing healthy food options helps with weight maintenance and reduces the risk of CKD by supporting healthy blood glucose and blood pressure levels. Balanced diets should include plenty of fruits, whole grains, starchy and non-starchy vegetables, some dairy, beans, lean proteins, eggs, and adequate healthy fats. Physical activity is a great tool that can help maintain weight and support stable blood pressure and blood glucose levels. Many types of activities are beneficial for reducing the risk of CKD. Some examples include walking, biking, and swimming. To learn more about physical activity, read HGIC 4030, Physical Activity Pyramid. Combining eating a healthful, balanced diet with routine physical activity are key elements of healthy weight management. 

Prevent Dehydration – Drinking sufficient amounts of water every day can support kidney health. The kidneys help the body to retain water when needed and excrete water through urine to maintain chemical balances in the body. Severe dehydration can cause kidney damage. A healthcare professional can help determine the proper amount of water a person needs to consume daily to maintain adequate hydration. It is important to choose beverages like water, low-fat milk, and unsweetened tea for hydration instead of sugary beverages like sodas and sweetened coffee drinks. Regularly consuming sugary beverages can have a negative impact on blood glucose management for people living with diabetes and their kidney health.

Avoid Pain Medication Overuse – Using too much pain medicine, specifically non-steroidal anti-inflammatory drugs, may cause kidney disease. The long-term use of these drugs reduces blood flow to the kidneys and can damage the kidneys. It is important to take medications as prescribed and ask your healthcare provider about other medicines that manage pain.  If you have concerns about your medications and your kidney health, talk with your healthcare provider.

Stop Smoking – There are many serious health problems associated with smoking cigarettes, including CKD. Smoking can interfere with some medications that are used to treat high blood pressure. Also, smoking causes restriction of blood flow to the kidneys, which can contribute to worsening CKD. Quitting smoking can help reduce the risk of CKD along with many other smoking-related illnesses like lung disease, cancer, and heart disease.   

Resources to Learn More

The National Kidney Foundation has many helpful resources for learning about kidney health. Their website includes online articles on a variety of topics, CKD-friendly recipes, and online communities for people to share their experiences.   

The American Kidney Fund has an entire website dedicated to kidney health in the kitchen. On their website, you can learn more about eating for the different stages of CKD. There are a wide variety of recipes that highlight the nutrients and the nutrient levels in the recipes.

The National Institute of Diabetes and Digestive and Kidney Diseases is a great resource to learn about numerous diseases and conditions, including diabetes and chronic kidney disease. The information on the website is informed by research and reviewed by doctors.  

References:  

Authors:

  • Kelsey Hillebrand, UPIC Intern, Clemson Cooperative Extension
  • Kathryn Flynn, Rural Health and Nutrition Agent, Oconee and Pickens Counties

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