Diabetes is the most common cause of CKD in the UK. But just because you have diabetes, it doesn’t mean you’ll end up with kidney problems.
If you take some simple steps, you can do your bit to prevent damage to your kidneys.
“Diabetes and kidney health go hand in hand,” says Collette Kelly, Diabetes Specialist Nurse, Liverpool Diabetes Partnership. “These conditions interact with each other so any positive changes you can make to your lifestyle will help your diabetes, kidneys and heart health too.”
Unfortunately, there’s no cure for kidney damage caused by diabetes, and no way to reverse it. But you can prevent the damage getting worse so it’s worth finding out as much as you can. The earlier kidney damage is spotted, the more can be done to help you.
Let’s look at some important steps to take.
1. Control your blood sugar
Make sure your blood sugar (glucose) levels stay within your target range. Your target range is something you’ll have agreed with your GP or practice nurse.
If you do have kidney damage, keeping good control of your blood sugar levels reduces the chances of it getting worse.
2. Keep your blood pressure low
If it’s left untreated, high blood pressure can harm your kidneys, as well as your heart, eyes and other organs
Healthy lifestyle habits like
- maintaining a healthy weight
- taking regular exercise
- cutting down on salt in food
- reducing the amount of alcohol you drink
- stopping smoking
can help with blood pressure. You might also need to take blood pressure tablets.
“You should aim to have blood pressure control that’s lower than the general population, so ideally less than 130/80,” says Professor Jeremy Levy, Consultant Nephrologist, Imperial College Healthcare NHS Trust. “Even though you may not feel any different there’s good evidence that it makes a significant difference to the risk that your kidney damage – if you have it – will get worse.”
3. Stop smoking if you smoke
Smoking can make kidney disease worse, as well as raising your risk of developing cancer, lung disease, heart disease and stroke.
Stopping smoking can be difficult but you can ask your GP or practice nurse for help.
4. Keep as active as possible
“For people with diabetes, regular exercise is as effective as almost any other treatment,” says Professor Levy. “It improves blood sugar control, can help with weight loss, improves blood pressure control and prevents risk of progression of kidney disease.”
5. Lose weight if you need to
Aim to eat healthily, and if you have a healthy eating plan try to stick to it.
“We know that most diabetics who develop kidney damage are type 2 diabetics,” says Professor Levy. “And type 2 diabetes is strongly associated with weight gain. So if you’re overweight and you can lose weight, in many cases you can reverse your diabetes or make it much less damaging.”
6. Ask your GP if you’re eligible for medication
“There are now two types of medicines that almost everyone with diabetes and kidney disease should be taking,” says Professor Levy. “If your GP surgery hasn’t contacted you already about starting on them, you may need to be proactive. They should be able to prescribe them without needing to refer you to a hospital first.”
The first type of medicine is a renin angiotensin system blocker, which includes:
● The family of drugs ending in ‘pril’ – including ramipril, lisinopril or perindopril
● The family of drugs ending in ‘sartan’ – including irbesartan, candesartan or olmesartan
These lower blood pressure and also protect your kidneys from ongoing damage.
The second type of medicine is a group of drugs called SGLT-inhibitors (prescribed to adults with type 2 diabetes). “Although these don’t reverse kidney damage, they slow it down. The best one for diabetics with kidney disease is dapagliflozin,” says Professor Levy.
“These SGLT-inhibitors are a newer group of drugs that have only been around a few years but were recently rapidly approved for UK use. All the trials show that if you take both drugs together they can be very effective.”
7. Go to all your appointments
Your medical appointments are important as any kidney damage can be spotted early.
As someone with diabetes, you should be having a regular check up every year (usually through your GP). This should also include a kidney check.
Your kidney check will be:
● a blood test to measure how well your kidneys are working. This works out the glomerular filtration rate (eGFR), which is how much blood your kidneys can filter every minute.
● a urine test to spot if a protein called albumin is in your wee (healthy kidneys filter out protein before it gets to your urine).
“The thing that sometimes gets missed is the urine sample,” says Professor Levy. “So make sure you get an appointment for this, and ask your GP to check your urine for protein. This is important because any protein in your urine is a sign of early kidney damage.”
“And after you’ve had an annual check, be proactive about making your next appointment. GPs don’t tend to book a year in advance so it might be up to you to remember to get booked in.”
For good tips on how to talk to your GP or practice nurse, read our guide to talking to health professionals about your kidney health.
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.