Diabetic kidney disease is a potential complication of diabetes. Over long periods of time, insufficiently controlled blood sugar can lead to kidney damage. While it is not possible to reverse kidney damage, people can prevent or delay kidney disease.

Diabetes is a condition that impairs the body’s ability to process blood sugar. It is also the leading cause of kidney disease, which some may refer to as diabetic nephropathy.

The kidneys are organs that play a role in maintaining homeostasis. The structures of the kidneys allow them to filter fluids and keep people healthy.

However, uncontrolled blood sugar can put extra stress on the kidneys and damage these structures. This damage can then result in kidney disease and other health problems.

To help maintain healthy kidneys and reduce the risk of kidney damage, a doctor may suggest that individuals living with diabetes make certain lifestyle changes. This may include maintaining hydration, altering their diet, and getting regular exercise.

In this article, we discuss how diabetes can affect the kidneys and what symptoms may occur. We also provide tips to maintain healthy kidney function.

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Diabetes is a condition that impedes the body’s ability to produce or correctly use the hormone insulin, impacting the regulation of blood glucose. This can lead to elevated blood sugar levels, which can cause health complications, such as kidney damage.

Evidence suggests that 1 in 3 adults with diabetes may have chronic kidney disease.

Diabetes can harm the kidneys by:

  • Damaging blood vessels: The kidneys contain a network of small blood vessels called glomeruli. These blood vessels filter waste products while keeping useful substances, such as proteins and red blood cells, in the blood. Over time, high blood sugar levels can cause microvascular damage due to the extra stress on this filtration system.
  • Increasing blood pressure: Damage to blood vessels and kidneys due to diabetes can also cause hypertension. This increase in blood pressure can put further strain on blood vessels around the kidneys, causing them to narrow, weaken, or harden.
  • Damaging nerves: Hyperglycemia, or high blood glucose levels, can cause nerve damage, or diabetic neuropathy. A type of this condition that health experts call autonomic neuropathy can affect functions such as urination. This can lead to a person not knowing when their bladder is full. This pressure can also cause further damage to the kidneys.

Many people may not notice any visible symptoms in the early stages of diabetic nephropathy.

However, blood and urine tests may help identify early stages of kidney damage. These tests can detect the presence of compounds that may indicate insufficient kidney function.

As kidney disease progresses, a person may begin to notice nonspecific symptoms. These typically occur as the kidneys struggle to remove fluid and waste from the body.

Symptoms may include:

If diabetic nephropathy progresses, a person may experience kidney failure and cardiovascular disease.

In addition to long periods of high blood sugar and blood pressure, other factors can increase the risk of diabetic nephropathy. Risk factors may include:

  • not following a diabetes care plan
  • not engaging in physical activity
  • following a diet high in salt
  • having obesity
  • smoking
  • having heart disease
  • having a family history of kidney failure
  • belonging to certain ethnic groups, such as African American, Native American, or Hispanic populations

It is not possible to reverse kidney damage. However, people can take measures to prevent or delay the onset of kidney disease.

Evidence notes that the best strategy for individuals living with diabetes is to manage blood glucose and keep levels within target range. Following the advice of a healthcare team can help a person control their blood sugar levels.

There are many steps people can take to ensure the health of their kidneys, including:

Additionally, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) emphasizes the importance of reaching blood glucose and blood pressure goals.

The NIDDK also notes that taking medications as a doctor prescribes is a key part of a treatment plan and can benefit the kidneys.

To help with tight control of blood glucose and blood pressure, a doctor may also suggest healthy lifestyle changes to improve kidney health. These may include:

A 2021 report notes that diabetes is a key risk factor for kidney disease. Evidence highlights that diabetic kidney disease is the leading cause of chronic kidney disease and end stage renal disease.

The authors of a 2020 review observe that diabetes may account for more than one-third of chronic kidney disease in the United States.

Moreover, research findings suggest that in 2019, diabetes was responsible for more than 2.5 million incident cases of chronic kidney disease.

When a person experiences kidney failure, there are two main treatment options: dialysis and transplantation.

Dialysis, or renal replacement therapy, is a procedure that mimics the natural work of kidneys. There are different types of dialysis, but it typically involves a machine and special fluid to remove harmful waste and extra salt and water from the blood.

A kidney transplant is a type of organ transplant that replaces the damaged kidney with a healthy one from a living or deceased donor.

It is advisable for a person living with diabetes to regularly test their kidney function. Checking kidney health should be a consistent part of their diabetes healthcare appointments. These tests can help identify early signs of kidney damage.

If an individual notices any of the above symptoms, they should seek medical attention.

Diabetes is the leading cause of kidney damage. This is due to long periods of high blood sugar causing damage to the delicate structures of the kidneys.

While it is not possible to reverse kidney damage resulting from diabetes, people can implement strategies to prevent or delay complications.

A person can achieve this by managing their blood sugar and blood pressure and making healthy lifestyle choices, such as getting regular exercise, staying hydrated, and altering their diet.