Diabetes is the leading cause of chronic kidney disease (CKD) and kidney failure.
Diabetic kidney disease—also called diabetic nephropathy—is kidney damage caused by long‑term high blood sugar. Over time, the kidneys’ filters (glomeruli) become leaky, allowing protein to spill into urine (albuminuria) and gradually reducing kidney function (eGFR).
Why it matters: DKD often has no symptoms in early stages. By the time swelling, fatigue, or poor appetite appear, damage can be advanced. Screening is essential.
Step‑by‑Step: How to Protect Your Kidneys If You Have Diabetes
Step 1: Know Your Risk
You are at higher risk if you:
Have type 1 or type 2 diabetes (especially >5–10 years),
Have high blood pressure, obesity, or a family history of kidney disease,
Smoke or have heart disease.
Step 2: Get the Right Tests—Every Year (or More Often)
Ask for these two simple tests:
Urine Albumin‑to‑Creatinine Ratio (UACR): detects protein leakage.
Target: < 30 mg/g (normal to mildly increased).
Estimated Glomerular Filtration Rate (eGFR): blood test that estimates kidney filtering capacity.
Target: ≥ 90 mL/min/1.73 m² is considered normal; lower values indicate CKD stages.
If UACR is ≥30 mg/g or eGFR <60, you likely have CKD and need a structured plan.
Step 3: Hit Your Sugar Targets
HbA1c: most adults aim for around 7% (your doctor may individualize).
Use your prescribed plan (diet, exercise, metformin/insulin/other agents).
Continuous glucose monitoring (CGM) or regular SMBG helps you stay in range.
Step 4: Control Your Blood Pressure
Goal: typically <130/80 mmHg (personalized by your clinician).
If albuminuria is present, medicines like ACE inhibitors or ARBs are commonly used because they protect kidneys beyond BP control.
Step 5: Ask About Kidney‑Protective Medicines
With your doctor, discuss:
ACE inhibitor or ARB (if albuminuria ≥30 mg/g), titrated to the max tolerated dose.
SGLT2 inhibitors (for many people with type 2 diabetes and CKD) to slow progression.
Finerenone (a non‑steroidal MRA) may be considered in persistent albuminuria despite ACEi/ARB.
Never start/stop these without medical advice; your labs (potassium, eGFR) need monitoring.
Step 6: Lifestyle That Loves Your Kidneys
Nutritious plate: more veggies, whole grains, lean proteins; limit salt; manage calories.
Move daily: aim for 150 minutes/week of moderate activity (as advised).
Quit smoking and maintain a healthy weight.
Sleep & stress: prioritize 7–8 hours sleep; manage stress to avoid glucose spikes.
Re‑check UACR & eGFR at least annually; every 3–6 months if abnormal.
Keep a personal record of BP, HbA1c, medications, and lab trends.
Step 8: See a Nephrologist Early
Consult a kidney specialist if you have:
UACR ≥30 mg/g on repeat testing,
eGFR <60, rising creatinine, or a rapid fall in eGFR,
Resistant hypertension, persistent swelling, or electrolyte issues,
Young age with kidney findings or uncertain cause.
Understanding Stages of CKD (Quick Table)
Stage eGFR (mL/min/1.73 m²) What it means
G1 ≥90 (with evidence of damage) Normal filtration with signs of kidney injury (e.g., albuminuria)
G2 60–89 Mildly decreased function
G3a 45–59 Mild‑to‑moderate decrease
G3b 30–44 Moderate‑to‑severe decrease
G4 15–29 Severe decrease
G5 <15 Kidney failure; dialysis/transplant may be required
Albuminuria categories:
A1: <30 mg/g • A2: 30–300 mg/g • A3: >300 mg/g
Signs & Symptoms (Often Late)
Foamy urine, swelling of ankles/face, frequent nighttime urination, fatigue, poor appetite, nausea, itching, muscle cramps.
Note: Many people feel normal until advanced stages—don’t wait for symptoms.
Treatment Pathway at Wellsun Medicity (Lucknow)
At Wellsun Medicity, our multidisciplinary team provides:
Early detection & risk assessment (UACR, eGFR, BP, HbA1c, lipid profile).
Personalized diabetes management (endocrinology + dietetics).
Kidney‑protective therapy optimization (ACEi/ARB, SGLT2i, MRA when appropriate).
Lifestyle & nutrition counseling for kidney‑smart living.
Advanced nephrology care including dialysis planning and transplant coordination when needed.
Call to Action: If you have diabetes, book your annual kidney check at Wellsun Medicity, Lucknow. Early control = long‑term kidney protection.
