March is National Kidney Month and was established to raise awareness about kidney disease. In the diabetes community, kidney disease is a major focus. Uncontrolled blood sugar levels are a leading factor contributing to the onset and advancement of kidney disease in people with diabetes. In fact, up to 40 percent of people with diabetes may have some level of kidney damage that over time may lead to kidney failure.
Kidneys are often one of our overlooked, but amazingly efficient and important organs. There are approximately one million filters in each of our kidneys, which carry waste and toxins from our bodies while adding nutrients and other critical substances back into our bloodstreams. Diabetes may damage the kidneys’ filters. That’s why it is important that everyone living with diabetes gets yearly routine screenings, which involve calculating an estimated kidney filtration rate called the eGFR. The eGFR is calculated from a blood test called serum creatinine. Normal eGFR is greater than 90 ml/min. While eGFR normally decreases with age, if you are living with diabetes, the routine checkup can determine if a decline is age-related or not.
Another factor your physician will check to determine if you are at risk for, or have kidney damage, is the amount of albumin in your urine. This is done by measuring the albumin/creatinine ratio in a single urine sample. Normal is <30 mg/g. If this level rises, then diabetes may be affecting the filters of the kidneys such that albumin is getting through. Think of the filters as colanders. The kidney filters normally prevent albumin from passing through, much like a colander prevents the lettuce you are rinsing from going through while allowing the water to pass. A rising urine albumin/creatinine ratio means a greater chance for loss of kidney filters over time.
But if you are living with diabetes, you can help prevent kidney disease. The main way to prevent kidney disease related to diabetes is to control your blood sugar. A second way is to control your blood pressure. Keeping those two factors in check will not only help prevent kidney damage but can lead to the prevention of other conditions like cardiovascular disease
If you are living with diabetes, work with your primary care physician to monitor your eGFR and your urine albumin/ creatinine ratio. If your eGFR is declining faster than the normal rate or is too low for your age, and your urine albumin/ creatinine ratio is steadily rising, it is time to seek care from a specialist in kidney disease. Kidney specialists are also experts in blood pressure control and can help you manage that too. Healthy kidneys are an important part of living a long healthy life with diabetes and should not be forgotten.
At Joslin Diabetes Center, our kidney care team includes specialists in diabetes and kidney disease. Together, they will monitor you, detect any early problems, and treat you should problems arise.
Although this content is reviewed by Joslin Diabetes Center healthcare professionals, it is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.