Table of ContentsView AllTable of ContentsWhat Kidneys DoDiabetes and KidneysSymptomsDiagnosis and TestsTreatmentPreventionFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

What Kidneys Do

Diabetes and Kidneys

Symptoms

Diagnosis and Tests

Treatment

Prevention

Frequently Asked Questions

Diabetesis the leading cause ofkidney disease. An estimated 1 in 3 adults with diabetes may develop kidney disease (also calleddiabetic nephropathy) in their lifetime.

An illustration with information about understanding the link between diabetes and kidney damage

What Your Kidneys Do

Thekidneysare two fist-sized, bean-shaped organs located on either side of the spine. Their main purpose is to filter your blood to remove wastes and maintain fluid and electrolyte balance. The kidneys also release hormones that regulate body systems such as blood pressure.

Your kidneys filter your body’s entire blood volume about 30 times per day. Blood is filtered several times while in the kidneys, which returns about 99% of the water in your blood back into the circulation system. The remaining water and any waste products are carried away through the production of urine.

The other vital function of the kidneys is to maintain fluid levels. Electrolytes like sodium and hormones like antidiuretic hormone(ADH), aldosterone, andatrial natriureticpeptide (ANP) play a role in this. These hormones respond to the body’s needs to increase or decrease fluid volume, maintaining blood pressure and the body’s overall homeostasis (balance).

Diabetes and Kidney Damage

Causes and Risk Factors of Kidney Damage

When the kidneys become injured, they lose their ability to retain essential protein, remove waste products from the blood, and maintain electrolyte and fluid homeostasis in the body.

The two main culprits of kidney damage related to diabetes are high blood pressure (hypertension) anduncontrolled blood sugar levels.

Hypertension in those with diabetes causesnephropathy, which is the deterioration of kidney function, because elevated blood pressure levels cause the blood vessels to stiffen. As a result, less oxygen-rich blood reaches the kidney, compromising the organ’s ability to function.

High blood pressure in the setting of diabetes is defined as a systolic blood pressure (top number) greater than or equal to 140 mmHg or a diastolic blood pressure (bottom number) greater than or equal to 90 mmHg.However, for individuals with diabetes, high blood pressure, and other risk factors for heart disease, a goal systolic blood pressure less than 130 mmHg and a diastolic blood pressure less than 80 mmHg may be appropriate if it is safe for you.

High blood pressure in the setting of diabetes is defined as a systolic blood pressure (top number) greater than or equal to 140 mmHg or a diastolic blood pressure (bottom number) greater than or equal to 90 mmHg.

However, for individuals with diabetes, high blood pressure, and other risk factors for heart disease, a goal systolic blood pressure less than 130 mmHg and a diastolic blood pressure less than 80 mmHg may be appropriate if it is safe for you.

High blood sugar levels are toxic to blood vessels, especially the small blood vessels that serve the kidneys. The mechanisms and pathways that lead to this damage are complicated and not well understood, but regulating blood sugar levels has been shown to improve kidney function.

Additional risk factors for diabetic nephropathy include:

Symptoms of Diabetic Nephropathy

Early on you may feel little to no symptoms at all, but as your kidney damage progresses you may begin to experience:

The closer you get to the final stage of diabetes nephropathy, calledkidney failure, or end-stage renal disease (ESRD), the more likely you will need specific medications or procedures to manage your symptoms.

What is a Nephrologist? When to See One and What to Expect

If you have diabetes,urineandblood testsare done on an ongoing basis to evaluate potential kidney damage.

Spilling albumin in urine is one common test to detect kidney disease. The presence of higher amounts of albumin in the urine is a sign that the kidneys are not functioning as well as they should.

The presence of high levels ofcreatinine, a waste product, indicates that the kidney’s filtration mechanism is compromised. Creatinine in the blood can provide information about the kidney’sglomerularfiltration rate (eGFR), or how well they are filtering blood.

Understanding Kidney Function Test Results

Treatment Options

If you develop end-stage renal disease, you may be a candidate forhemodialysis, especially if you are on the waiting list for a kidney transplant.

Hemodialysisis the process of mechanically filtering blood via a machine. In the procedure, blood is removed from the body, put through the machine, filtered, and then placed back into the body. This is done at a hospital dialysis unit or clinic and must be repeated three or four days per week.

5 Complications of Hemodialysis

Preventing Diabetic Kidney Disease

Careful control of your blood sugar (glucose) levels can help slow the progression, or perhaps prevent, kidney disease. This usually requires a combination of lifestyle changes, including eating a diet low in sodium and sugar, and taking insulin or oral medication.

Summary

High blood sugar levels that characterize diabetes can slowly damage the kidneys over time, disrupting its ability to filter blood throughout the body. Early diagnosis and treatment can help you manage your blood sugar levels, slowing the progression and in some cases, preventing the development of diabetic kidney disease.

A Word From Verywell

If you are diagnosed with diabetic nephropathy, the best treatment for you will be based on your age, overall health, extent of disease, tolerance for specific medications, procedures, or therapies, and your opinion or preference.

Frequently Asked QuestionsAccording to the Centers for Disease Control and Prevention (CDC), about approximately 1 in 3 adults with diabetes has chronic kidney disease (CKD).Sometimes kidney damage causes blood to enter the urine which may cause your urine to darken in color.Chronic kidney damage cannot be reversed, but careful control of your blood pressure and blood sugar levels, as well as taking your medications as prescribed, can slow the progression of your kidney disease.Diabetic kidney disease is a chronic, progressive condition that worsens over time without treatment.

According to the Centers for Disease Control and Prevention (CDC), about approximately 1 in 3 adults with diabetes has chronic kidney disease (CKD).

Sometimes kidney damage causes blood to enter the urine which may cause your urine to darken in color.

Chronic kidney damage cannot be reversed, but careful control of your blood pressure and blood sugar levels, as well as taking your medications as prescribed, can slow the progression of your kidney disease.

Diabetic kidney disease is a chronic, progressive condition that worsens over time without treatment.

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.CDC.Diabetes and chronic kidney disease.Johns Hopkins Medicine.Anatomy of the urinary system.Sternlicht H, Bakris GL.Management of hypertension in diabetic nephropathy: how low should we go?.Blood Purif. 2016;41(1-3):139-143. doi:10.1159/000441264Johns Hopkin.Diabetic nephropathy.Tziomalos K, Athyros VG.Diabetic nephropathy: new risk factors and improvements in diagnosis.Rev Diabet Stud. 2015;12(1-2):110-118. doi:10.1900/RDS.2015.12.110American Kidney Fund.Blood test: eGFR.Samsu N.Diabetic nephropathy: Challenges in pathogenesis, diagnosis, and treatment.Biomed Res Int. 2021;2021:1497449. doi:10.1155/2021/1497449Food and Drug Administration.FDA approves drug to reduce risk of serious kidney and heart complications in adults with chronic kidney disease associated with type 2 diabetes.

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.CDC.Diabetes and chronic kidney disease.Johns Hopkins Medicine.Anatomy of the urinary system.Sternlicht H, Bakris GL.Management of hypertension in diabetic nephropathy: how low should we go?.Blood Purif. 2016;41(1-3):139-143. doi:10.1159/000441264Johns Hopkin.Diabetic nephropathy.Tziomalos K, Athyros VG.Diabetic nephropathy: new risk factors and improvements in diagnosis.Rev Diabet Stud. 2015;12(1-2):110-118. doi:10.1900/RDS.2015.12.110American Kidney Fund.Blood test: eGFR.Samsu N.Diabetic nephropathy: Challenges in pathogenesis, diagnosis, and treatment.Biomed Res Int. 2021;2021:1497449. doi:10.1155/2021/1497449Food and Drug Administration.FDA approves drug to reduce risk of serious kidney and heart complications in adults with chronic kidney disease associated with type 2 diabetes.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

CDC.Diabetes and chronic kidney disease.Johns Hopkins Medicine.Anatomy of the urinary system.Sternlicht H, Bakris GL.Management of hypertension in diabetic nephropathy: how low should we go?.Blood Purif. 2016;41(1-3):139-143. doi:10.1159/000441264Johns Hopkin.Diabetic nephropathy.Tziomalos K, Athyros VG.Diabetic nephropathy: new risk factors and improvements in diagnosis.Rev Diabet Stud. 2015;12(1-2):110-118. doi:10.1900/RDS.2015.12.110American Kidney Fund.Blood test: eGFR.Samsu N.Diabetic nephropathy: Challenges in pathogenesis, diagnosis, and treatment.Biomed Res Int. 2021;2021:1497449. doi:10.1155/2021/1497449Food and Drug Administration.FDA approves drug to reduce risk of serious kidney and heart complications in adults with chronic kidney disease associated with type 2 diabetes.

CDC.Diabetes and chronic kidney disease.

Johns Hopkins Medicine.Anatomy of the urinary system.

Sternlicht H, Bakris GL.Management of hypertension in diabetic nephropathy: how low should we go?.Blood Purif. 2016;41(1-3):139-143. doi:10.1159/000441264

Johns Hopkin.Diabetic nephropathy.

Tziomalos K, Athyros VG.Diabetic nephropathy: new risk factors and improvements in diagnosis.Rev Diabet Stud. 2015;12(1-2):110-118. doi:10.1900/RDS.2015.12.110

American Kidney Fund.Blood test: eGFR.

Samsu N.Diabetic nephropathy: Challenges in pathogenesis, diagnosis, and treatment.Biomed Res Int. 2021;2021:1497449. doi:10.1155/2021/1497449

Food and Drug Administration.FDA approves drug to reduce risk of serious kidney and heart complications in adults with chronic kidney disease associated with type 2 diabetes.

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?OtherHelpfulReport an ErrorSubmit

What is your feedback?