Understanding Diabetes Complications: Kidney Health

Understanding Diabetes Complications: Kidney Health: Main Image
There are two very important ways to reduce kidney disease risk and delay the progression to kidney failure if the disease is already present

The kidneys are the body’s filtering system, clearing waste from blood, regulating the body’s fluid and electrolyte balance, and producing urine. The kidneys also activate vitamin D, support red blood cell production, and play a vital role in managing blood pressure.

Kidney disease is a common diabetes complication; however, if caught early, it can often be managed without aggressive treatments like dialysis. If diabetic kidney disease becomes advanced, it generally leads to kidney failure. When this happens, a person must undergo regular dialysis, or receive a kidney transplant.

The keys to kidney care

There are two very important ways to help reduce kidney disease risk and delay the progression to kidney failure if the disease is already present:

  • Maintain blood glucose values in the target range
  • Maintain healthy blood pressure

Other helpful strategies

Some people may also benefit from special diets. For example, although some people with diabetes may be encouraged to increase their protein as a way of lowering their diet’s glycemic load, your doctor may want you to stick to the usual recommended daily intake for protein—0.8 g/kg of body weight per day, or about 46 g per day for women and 56 g per day for men.

People (with or without diabetes) generally benefit from limiting sodium intake to 2,300 mg per day. High blood pressure puts additional stress on the kidneys, and kidney damage can disrupt fluid balance and contribute to high blood pressure. If you have high blood pressure, your healthcare provider may recommend further reducing sodium intake to as low as 1,500 mg per day.

Finally, eating a diet that meets or exceeds the recommended minimum daily intake of fiber—25 g per day for women and 38 g per day for men—may help people with diabetes manage blood glucose levels and avoid certain cardiovascular and kidney complications. Although fiber from food has demonstrated more benefits in people with diabetes, fiber supplements may be recommended in some cases.

If you or your loved one has diabetic kidney disease, it’s important to work with a healthcare provider with expertise in nutrition when changing your diet. They can help you develop an eating plan so you can reach your dietary goals, safely. This is important because, in people with advanced kidney disease, a high-fiber diet (which generally is also high in potassium) can cause serious elevations of blood potassium levels.

(Diabetes Care 2016;39:s1–112)

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