(bite and munching sound)
So, you've heard that diabetes can cause problems with your kidneys.
Let's talk about that. Diabetes happens when the sugar levels in your blood
are too high. When the sugar levels in your blood are too high for too long,
this can cause damage to your body, for example, to your kidneys. Your kidneys sit
just below your ribs, near your back. Their job is to filter your blood and
get rid of waste products, and extra salt and water into your urine or pee.
If they become damaged, they can't do that job properly. When kidney damage happens in
someone living with diabetes, it sometimes goes by different names,
like diabetic kidney disease, diabetic nephropathy, or more generally chronic
kidney disease, or CKD. If diabetic kidney disease damages the kidneys very badly,
then the waste products and extra salt and water need to be removed another way,
by either dialysis or a kidney transplant.
Dialysis involves artificially filtering the blood several times a week, and a transplant involves
receiving a new kidney from a donor. Around four in 10 people living with
diabetes may develop some signs of kidney disease in their lifetimes,
but most people with diabetic kidney disease don't end up with kidney failure that
needs dialysis or a transplant. And the good news is, that if you take care of
your diabetes, and even if you have kidney damage, then there are lots of
things you can do to slow the loss of kidney function. We'll talk about that a
bit later. Kidney damage usually doesn't cause any symptoms when it's at its
early stages, but the lab tests you do for your doctors are able to pick up
early signs of kidney damage. This is called screening. Usually doctors will do
two screening tests every year to check on your kidneys. One test is a urine test
looking to see if proteins have leaked into your urine, a sign that the tiny
filters in the kidneys are damaged. This test is often called an albumin
creatinine ratio, or ACR, and a normal test result would be less than 2
milligrams per millimole. The second test is a blood test to see how well your kidneys
are filtering. The less they are filtering, the more damage they have had.
This test is often called an eGFR. A normal test result would be more than 90,
but people usually don't need medication changes unless the number is less than 60.
If your tests show that you have early signs of kidney damage, your doctor
may prescribe medications for you. These may include: blood pressure medications,
particularly pills called ACE inhibitors or ARBs; medications that help control
your blood sugar, including medications called SGLT2 inhibitors in some people;
cholesterol medications, called statins, to help keep your heart healthy. And they
may ask a dietitian to give you special diet advice. Here's some tips to help
keep you and your kidneys healthy. Most important is to keep your blood sugar
under control, and to keep your blood pressure under control.
Talk to your diabetes care team about your targets to control your blood sugar
and blood pressure. Take your medications as prescribed, and keep your health-care
appointments. Don't smoke. Maintain a healthy weight and stay physically active.
Follow the recommendations of your dietitian. Sometimes, if you get sick
for another reason, then the medications that you take can
actually become harmful. Talk to your health care team about a sick day plan.
It's normal to worry about your future health from time to time.
By taking your medications, having your screening tests, making healthy choices,
and working with your diabetes care team, know that you're making the best
investment possible for you to enjoy a long healthy future.