Diabetes, High Blood Pressure and Your Kidneys

Diabetes and high blood pressure increase your risk of kidney disease. People with diabetes are three times more likely to have high blood pressure than someone without diabetes. You can lower your risk for kidney disease by controlling your diabetes, blood pressure, and by maintaining a healthy lifestyle.

Diabetes

Diabetes is the leading cause of kidney disease in the U.S, accounting for almost half of all new cases. Diabetes damages the small blood vessels of the kidney which can lead to loss of function. These blood vessel changes can also affect the skin, nerves, muscles, intestines, and the heart.

Treatment should begin early and includes controlling diabetes to slow the advance to kidney failure:

• Maintain blood sugar and blood pressure within a healthy range
• Regular testing
  • Microalbumin, protein found in the urine
  • Glomerular filtration rate (GFR), a measure of kidney function

Questions to ask your doctor:

1. What should my blood sugar range be?
2. What is my A1C?
3. How often should I check my blood sugar?
4. How can I help control my blood sugar?
5. Should I see a diabetes specialist?
6. Should I talk with a dietitian?
7. Am I taking the right medicines for my diabetes?
8. Should I have blood or urine tests to check kidney function?

High Blood Pressure

High blood pressure is the second leading cause of kidney disease in the U.S., leading to one fourth of the new cases. Uncontrolled or poorly controlled blood pressure can cause permanent damage to the blood vessels of the kidney, decreasing the ability to filter fluids and waste from the blood.

Early detection and treatment of even mild high blood pressure is important to slow the advance of kidney disease:

• Maintain blood pressure within a healthy range
• Use medicines such as ACE inhibitors and ARBS if ordered by doctor (not everyone can take these medicines)

Many organizations, such as the American Heart Association (AHA) and the American Diabetes Association (ADA) have recommendations about blood pressure readings. Talk to your doctor about what your target blood pressure should be. Keeping your blood pressure within a healthy range will lower your risk for problems.

Questions to ask your doctor:

1. What is my blood pressure?
2. What can I do to lower my blood pressure?
3. Should I be on blood pressure medicine?
4. Do I need a blood pressure monitor to check my blood pressure at home?
5. How often should I check my blood pressure?
6. Should I have blood or urine tests to check kidney function?

Kidney Function

Diabetes and high blood pressure are the two most common causes of kidney disease. Ask your doctor about your kidney function.

Questions to ask your doctor:

1. Am I at risk for kidney disease?
2. What signs and symptoms are there for kidney damage?
3. Are there blood or urine tests I should be having, and how often?
4. Do I have kidney disease now?
5. If so, what stage am I?
6. How often will you track my glomerular filtration rate (GFR)?
7. How will I know if my kidney function has changed?
8. When should I see a kidney specialist?

Delaying Kidney Disease

If you have kidney disease there are ways to help keep your kidneys working well as long as they can. One of the most important things you can do is learn as much as you can and ask questions.

Questions to ask your doctor:

• How can I protect my kidneys?
• What can I do to avoid or delay kidney disease?
• Are there medicines I should avoid?
• Are there medicines I should take to protect my kidneys?
• What changes should I make in my diet?
• How can I stop smoking?
• How often should I see my doctor?
• Should I see a kidney specialist?