Here are some helpful tips:. In one study , researchers noted that including more fruits and vegetables in your diet can minimize your risk for kidney injury and metabolic acidosis.

An overabundance of acid can cause potentially dangerous symptoms, such as rapid breathing, fatigue, confusion, and — in extreme cases — even shock or death. Fruits and veggies help the kidneys remove excess acid from the body and excrete it in urine.

Adding more fruits and vegetables has specifically helped patients with chronic kidney disease , who are most susceptible to metabolic acidosis.

These patients are usually treated with bicarbonate and other alkali supplements. The researchers randomly treated 71 patients who had stage 4 chronic kidney disease with either a diet including fruits and vegetables or an oral alkaline medicine.

Both groups showed similar kidney function, decreased rates of metabolic acidosis, and lowered rates of kidney injury. The researchers argued in their paper that these interventions may help improve kidney health in people diagnosed with kidney disease.

But be sure to talk to your doctor about the right diet for you. Some patients with kidney disease may need to limit intake of potassium, which can be higher in certain fruits and vegetables.

A study in Kidney International reported that omega-3 fatty acids, like those found in fish oil, may protect dialysis patients from sudden cardiac death.

The researchers looked at blood levels of omega-3 fatty acids in dialysis patients, of whom had died within their first year of treatment. The risk of sudden cardiac death is highest during the first year of dialysis. The researchers observed in their paper that, during the first year of a patient beginning hemodialysis, those participants who had higher levels of omega-3 fatty acids — which are found in fatty fish, like salmon and tuna, as well as flaxseed and walnuts — had a lower risk of sudden cardiac death.

The study offered some clues for new treatments against sudden cardiac death in people with kidney disease who are undergoing dialysis. Eating too many salty foods can also increase the risk of high blood pressure, possibly leading to heart disease and stroke, which people with diabetes are already at a greater risk of developing, notes Johns Hopkins Medicine.

As noted earlier, 1 in 3 American adults with diabetes has kidney disease, per the NIDDK , but managing diabetes well can help keep your kidneys healthy and prevent disease. In addition to eating too much salt and not following a diabetes-friendly diet, being overweight, physically inactive, and smoking are some of the factors that can increase your risk of kidney disease if you have diabetes.

Having a family history of kidney failure can also be a risk factor, and people with diabetes who are Black, Hispanic, or Asian American may also be more likely to develop kidney disease or kidney failure, per the National Kidney Foundation.

According to a research review , regular exercise benefits those living with CKD, as well as those who have undergone a kidney transplant.

The review notes that people who exercised not only improved their overall physical fitness, but they also had healthier blood pressure and heart rates, as well as overall good nutrition and lifestyle profiles. In analyzing 45 different studies with more than 1, participants, the researchers found that patients on dialysis, those who did not yet need dialysis, and recipients of transplants all benefited from exercise.

Resistance training aided walking ability, yoga helped with muscle strength, and cardiovascular exercise improved aerobic capacity. For more info on the rela tionship between kidney stones and diabetes, check out this article from Diabetes Daily! Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy.

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Health Tools. Body Type Quiz Find a Doctor - EverydayHealth Care Hydration Calculator Menopause Age Calculator Symptom Checker Weight Loss Calculator. Take all your medicines as prescribed. Talk with your health care provider about certain blood pressure medicines, called ACE inhibitors and ARBs , which may protect your kidneys.

The names of these medicines end in —pril or —sartan. Be careful about the daily use of over-the-counter pain medications. Regular use of nonsteroidal anti-inflammatory drugs NSAIDs , such as ibuprofen and naproxen , can damage your kidneys. Learn more about over-the-counter medicines and your kidneys.

To help prevent heart attacks and stroke, keep your cholesterol levels in the target range. There are two kinds of cholesterol in your blood: LDL and HDL. A cholesterol test also may measure another type of blood fat called triglycerides.

Ask your health care provider the following key questions about your kidney health during your next medical visit.

The sooner you know you have kidney disease, the sooner you can get treatment to help protect your kidneys. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK , part of the National Institutes of Health.

NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.

Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts. Home Health Information Kidney Disease Chronic Kidney Disease CKD Preventing CKD. English English Español Français. Chronic Kidney Disease CKD What Is Chronic Kidney Disease?

Eating Right Show child pages. You are more likely to develop kidney disease if you have diabetes high blood pressure heart disease a family history of kidney failure What can I do to keep my kidneys healthy? Make healthy food choices Choose foods that are healthy for your heart and your entire body: fresh fruits, fresh or frozen vegetables, whole grains, and low-fat or fat-free dairy products.

Choose foods that are healthy for your body. Tips for making healthy food choices Cook with a mix of spices instead of salt. Choose veggie toppings such as spinach, broccoli, and peppers for your pizza.

Try baking or broiling meat, chicken, and fish instead of frying. Serve foods without gravy or added fats. Try to choose foods with little or no added sugar. Eat foods made from whole grains—such as whole wheat, brown rice, oats, and whole-grain corn—every day.

Use whole-grain bread for toast and sandwiches; substitute brown rice for white rice for home-cooked meals and when dining out.

Read food labels. Choose foods low in saturated fats, trans fats, cholesterol, salt sodium , and added sugars. Slow down at snack time. For them, ARBs are often a good alternative, because ARBs do not cause a cough.

In rare cases, you can have more serious side effects with ACE inhibitors and ARBs. These include a condition called hyperkalemia, in which too much potassium accumulates in the blood. To monitor for these and other side effects, health care providers sometimes run blood tests soon after starting these drugs.

In some people, the medications will need to be stopped. SGLT2 inhibitors — In addition to the measures described above, some people with type 2 diabetes and kidney disease will get a medication called a sodium-glucose co-transporter 2 SGLT2 inhibitor.

These medications lower blood sugar by increasing the excretion of sugar in the urine; they include canagliflozin brand name: Invokana , empagliflozin brand name: Jardiance , and dapagliflozin brand name: Farxiga. Your health care provider can talk to you about whether you are a candidate for treatment with an SGLT2 inhibitor if you do not already take one ; this will depend on how advanced your kidney disease is and how much albumin is in your urine.

Ongoing monitoring — After beginning treatment and lifestyle changes to stall kidney disease, you will need to have repeat urine and blood tests to determine if urine albumin levels have improved.

If the urine albumin levels have not improved or your kidney function has worsened, your health care provider may need to adjust your medications or recommend other strategies to protect your kidneys. PREGNANCY AND DIABETIC KIDNEY DISEASE. If you have diabetes and are interested in getting pregnant, it is important to talk with your health care provider well in advance, especially if you have diabetic kidney disease.

Diabetes and its attendant problems can increase the risk of complications in pregnancy, especially in women with decreased kidney function. However, many women with mild diabetic kidney disease have normal pregnancies and healthy babies.

To ensure the best outcome with a pregnancy, the most important thing you can do is to keep your blood sugar and blood pressure under tight control. However, women who are pregnant or attempting to get pregnant should not take angiotensin-converting enzyme ACE inhibitors or angiotensin receptor blockers ARBs , as these drugs can cause birth defects.

Instead, other medications such as calcium channel blockers are used during pregnancy to keep the blood pressure in check. See "Patient education: Care during pregnancy for patients with type 1 or 2 diabetes Beyond the Basics ".

If the steps you need to take to protect your kidneys sound overwhelming, keep this in mind; controlling your blood sugar and blood pressure can help to reduce the risk or severity of several other debilitating diabetes complications, including:.

The same measures that are used in the treatment of diabetic kidney disease are also useful in preventing it. That's true for the lifestyle choices mentioned above, as well as for the tight control of blood sugar levels and blood pressure.

Your health care provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our web site www. Related topics for patients, as well as selected articles written for health care professionals, are also available.

Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Type 2 diabetes The Basics. Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon. Patient education: Chronic kidney disease Beyond the Basics Patient education: Dialysis or kidney transplantation — which is right for me?

Beyond the Basics Patient education: Diabetic neuropathy Beyond the Basics Patient education: Protein in the urine proteinuria Beyond the Basics Patient education: Low-sodium diet Beyond the Basics Patient education: Quitting smoking Beyond the Basics Patient education: Diet and health Beyond the Basics Patient education: Exercise Beyond the Basics Patient education: Losing weight Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: High blood pressure in adults Beyond the Basics Patient education: High blood pressure, diet, and weight Beyond the Basics Patient education: High blood pressure treatment in adults Beyond the Basics Patient education: Care during pregnancy for patients with type 1 or 2 diabetes Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.

These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Antihypertensive therapy and progression of nondiabetic chronic kidney disease in adults Moderately increased albuminuria microalbuminuria in type 1 diabetes mellitus Moderately increased albuminuria microalbuminuria in type 2 diabetes mellitus Diabetic kidney disease: Pathogenesis and epidemiology Kidney transplantation in diabetic kidney disease Treatment of diabetic kidney disease Major side effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers Pregnancy and contraception in patients with nondialysis chronic kidney disease.

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Patient education: Diabetic kidney disease Beyond the Basics. Formulary drug information for this topic. No drug references linked in this topic.

Find in topic Formulary Print Share. Author: George L Bakris, MD Section Editors: Richard J Glassock, MD, MACP David M Nathan, MD Deputy Editor: John P Forman, MD, MSc Contributor Disclosures. All topics are updated as new evidence becomes available and our peer review process is complete.

Literature review current through: Jan This topic last updated: Mar 15,

Diabetes Res Clin Pract. Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among adults in the United States, — Murphy D, McCulloch CE, Lin F, et al.

Trends in prevalence of chronic kidney disease in the United States. Ann Intern Med. Saran R, Robinson B, Abbott KC, et al. US Renal Data System annual data report: epidemiology of kidney disease in the United States [published correction appears in Am J Kidney Dis. Am J Kidney Dis.

Tuttle KR, Bakris GL, Bilous RW, et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR UKPDS Group.

Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study UKPDS Kidney Int.

Macisaac RJ, Ekinci EI, Jerums G. Markers of and risk factors for the development and progression of diabetic kidney disease. Dunkler D, Kohl M, Heinze G, et al. Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus.

American Diabetes Association. Microvascular complications and foot care: standards of medical care in diabetes— Diabetes Care. Reidy K, Kang HM, Hostetter T, Susztak K. Molecular mechanisms of diabetic kidney disease.

J Clin Invest. Clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Levin A, Stevens PE, Bilous RW, et al. KDIGO clinical practice guideline for the evaluation and management of chronic kidney disease.

Kidney Int Suppl. Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes [published correction appears in N Engl J Med.

N Engl J Med. Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. Patel A, MacMahon S, Chalmers J, et al.

Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. Glycemic targets: standards of medical care in diabetes— Qaseem A, Wilt TJ, Kansagara D, Horwitch C, Barry MJ, Forciea MA Clinical Guidelines Committee of the American College of Physicians.

Hemoglobin A1c targets for glycemic control with pharmacologic therapy for nonpregnant adults with type 2 diabetes mellitus: a guidance statement update from the American College of Physicians. Ismail-Beigi F, Craven T, Banerji MA, et al. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial [published correction appears in Lancet.

Groop PH, Cooper ME, Perkovic V, Emser A, Woerle HJ, von Eynatten M. Linagliptin lowers albuminuria on top of recommended standard treatment in patients with type 2 diabetes and renal dysfunction.

Groop PH, Cooper ME, Perkovic V, et al. Linagliptin and its effects on hyperglycaemia and albuminuria in patients with type 2 diabetes and renal dysfunction: the randomized MARLINA-T2D trial. Diabetes Obes Metab. Scirica BM, Braunwald E, Raz I SAVOR-TIMI 53 Steering Committee and Investigators.

Heart failure, saxagliptin and diabetes mellitus: observations from the SAVOR-TIMI 53 randomized trial [published correction appears in Circulation. Marso SP, Daniels GH, Brown-Frandsen K, et al.

Liraglutide and cardiovascular outcomes in type 2 diabetes. Fujita H, Morii T, Fujishima H, et al. The protective roles of GLP-1R signaling in diabetic nephropathy: possible mechanism and therapeutic potential. Marso SP, Bain SC, Consoli A, et al.

Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. Palmer SC, Mavridis D, Nicolucci A, et al. Comparison of clinical outcomes and adverse events associated with glucose-lowering drugs in patients with type 2 diabetes: a meta-analysis.

UK Prospective Diabetes Study UKPDS Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes UKPDS 34 [published correction appears in Lancet. Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and progression of kidney disease in type 2 diabetes.

Barnett AH, Mithal A, Manassie J, et al. Efficacy and safety of empagliflozin added to existing antidiabetes treatment in patients with type 2 diabetes and chronic kidney disease: a randomised, double-blind, placebo-controlled trial.

Lancet Diabetes Endocrinol. Sarafidis PA, Bakris GL. Protection of the kidney by thiazolidinediones: an assessment from bench to bedside. Heerspink HJ, Desai M, Jardine M, Balis D, Meininger G, Perkovic V.

Canagliflozin slows progression of renal function decline independently of glycemic effects. J Am Soc Nephrol. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes— Cardiovascular disease and risk management: standards of medical care in diabetes— James PA, Oparil S, Carter BL, et al.

Whelton PK, Carey RM, Aronow WS, et al. J Am Coll Cardiol. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38 [published correction appears in BMJ.

Cushman WC, Evans GW, Byington RP, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. Visit a nephrologist if you notice a decline in kidney function, such as:.

They can assess the extent of kidney damage and recommend appropriate interventions to slow down disease progression. If you have diabetes and struggle to manage your blood pressure effectively, consulting a nephrologist is beneficial. They specialize in managing hypertension associated with kidney diseases and can provide targeted treatment plans to control blood pressure and protect kidney function.

If diabetic kidney disease has progressed to advanced stages or end-stage renal disease, a nephrologist can discuss treatment options such as:. Do you have multiple health conditions alongside diabetic kidney disease , such as heart disease or other complications?

A nephrologist can work collaboratively with other specialists to ensure comprehensive and coordinated care. Nephrologists can provide valuable education and guidance regarding lifestyle modifications, dietary restrictions, and medication management specific to diabetic kidney disease.

They can empower you with knowledge and resources to actively participate in your own kidney health management. Early detection and intervention are key to effectively managing diabetic kidney disease. If you have diabetes, work closely with your healthcare team to develop a personalized prevention and management strategy that suits your specific needs.

Together, you can reduce the risk of diabetic kidney disease and maintain optimal kidney health. Are you searching for the best nephrologist near you? If so, look no further than the healthcare providers at Associates in Nephrology.

With us, you can rest assured you will receive nothing short of the best care. Call us today at for any questions or concerns. You can also book an appointment with our secure online request form. Our kidney care specialist s at Associates in Nephrology specialized training and experience needed to diagnose and treat kidney conditions such as Chronic Kidney Disease , Electrolyte Disorders , End-Stage Kidney Disease, Glomerulonephritis, Hypertension, Kidney Stones, Kidney Transplant , and Renal Failure.

Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. Editorial team.

Share Facebook Twitter Linkedin Email Home Health Library. Diabetes and kidney disease Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease. The urinary system is made up of the kidneys, ureters, urethra and bladder.

Causes Each kidney is made of hundreds of thousands of small units called nephrons. Kidney damage is more likely if you: Have uncontrolled blood sugar glucose Are obese Have high blood pressure Have type 1 diabetes that began before you were 20 years old Have family members who also have diabetes and kidney problems Smoke Are African American, Mexican American, or Native American.

Symptoms Often, there are no symptoms as the kidney damage starts and slowly gets worse. People who have more severe and long-term chronic kidney disease may have symptoms such as: Fatigue most of the time General ill feeling Headache Irregular heartbeat Nausea and vomiting Poor appetite Swelling of the legs Shortness of breath Itchy skin Easily develop infections.

Exams and Tests Your health care provider will order tests to detect signs of kidney problems. A urine test looks for a protein, called albumin, leaking into the urine. Too much albumin in the urine is often a sign of kidney damage.

This test is also called a microalbuminuria test because it measures small amounts of albumin. If you have diabetes, your provider will also check your kidneys by using the following blood tests every year: Blood urea nitrogen BUN Serum creatinine Estimated glomerular filtration rate eGFR.

Treatment When kidney damage is caught in its early stages, it can be slowed with treatment. Follow your provider's advice to keep your condition from getting worse.

Your provider will prescribe blood pressure medicines known as ACE inhibitors or angiotensin II receptor blockers to protect your kidneys from more damage if your microalbumin test is too high on at least two measurements. If your blood pressure is in the normal range and you have microalbuminuria, you may still benefit from these medicines.

Your provider can help you decide what is best for you. CONTROL YOUR BLOOD SUGAR LEVEL You can also slow kidney damage by controlling your blood sugar level through: Eating healthy foods Getting regular exercise Taking oral or injectable medicines as instructed by your provider Some diabetes medicines are known to prevent the progression of diabetic nephropathy better than other medicines.

Talk to your provider about which medicines are best for you. Checking your blood sugar level as often as instructed and keeping a record of your blood sugar numbers so that you know how meals and activities affect your level OTHER WAYS TO PROTECT YOUR KIDNEYS Contrast dye that is sometimes used with an MRI, CT scan, or other imaging test can cause more damage to your kidneys.

Tell the provider who is ordering the test that you have diabetes. Follow instructions about drinking lots of water after the procedure to flush the dye out of your system.

Avoid taking an NSAID pain medicine, such as ibuprofen or naproxen. Ask your provider if there is another kind of medicine that you can take instead. NSAIDs can damage the kidneys, more so when you use them every day. Your provider may need to stop or change other medicines that can damage your kidneys.

Know the signs of urinary tract infections and get them treated right away. Having a low level of vitamin D may worsen kidney disease. Ask your doctor if you need to take vitamin D supplements. Do not use tobacco. Support Groups Many resources can help you understand more about diabetes.

Outlook Prognosis Diabetic kidney disease is a major cause of sickness and death in people with diabetes. When to Contact a Medical Professional Contact your provider if you have diabetes and you have not had a urine test to check for protein. References Brownlee M, Aiello LP, Sun JK, et al.