What Are the Signs of Kidney Damage? continued...
People with diabetes who are at risk for kidney damage need these three tests, experts say.
- Blood pressure monitoring. High blood pressure can be a sign of kidney problems, and it can also contribute to them. Stanton says that people with diabetes and kidney disease usually need to maintain good control of their blood pressure. Aiming for a reading below 130/80 is usually a good target, Stanton says.
- Urine tests for protein, creatinine, and albumin. When the kidneys are damaged, tiny amounts of protein begin to leak into the urine. Your doctor can test your urine to check for the presence of protein, creatinine, and albumin. While getting an accurate reading used to mean collecting your urine for 24 hours, Stanton says that's no longer necessary. You just need a single sample.
- Estimated Glomerular Filtration Rate (eGFR or GFR.) This is a number based on results from a blood test for creatinine levels. It helps show how well your kidneys are filtering the blood. "I think every patient should know his GFR," says Stanton.
If you're not sure whether you've had these tests, ask your doctor, Stanton says.
Treatment for Diabetes and Kidney Damage
If you already have signs of early kidney damage, a number of treatments may help.
- Lifestyle changes. Eating a healthier diet and exercising more can have a dramatic impact on blood glucose levels. Some people benefit from a diet that's low in protein. If you smoke, quit. Controlling lipids -- cholesterol and triglycerides -- may not have a direct effect on kidney function, but it can help lower the risk of heart disease.
- Home monitoring. In addition to checking your blood glucose at home, you may need to closely monitor your blood pressure, too.
- Medications. Drugs called ACE-inhibitors and angiotensin receptor blockers (ARBs) can help slow or prevent kidney disease in those with high blood pressure.
End stage kidney disease or kidney failure is treated with dialysis or a transplant. While kidney failure is a serious risk of diabetes, most people with diabetes never develop kidney failure. With good treatment, even people who do have severe kidney disease can sometimes delay dialysis for many years, says Stanton.
Diabetes and Kidney Disease: Taking Control of Your Health
Stanton says that people with diabetes, or even prediabetes, shouldn't be afraid to push for information about their risks of kidney problems.
"The biggest mistake is not to ask your doctor," says Stanton. If you get the tests and don't have any signs of kidney problems, you'll be relieved. If you do have some signs, the sooner you start treatment the better.
"Aggressive management of diabetes and kidney disease can make a huge difference," Stanton says, "but you have to know you have the condition before you can get treatment."