Kidney health

Your kidneys act as a natural filter for your body. They clean your blood, removing waste products and extra fluid, which leave your body as urine.

In diabetes, high blood glucose levels and high blood pressure can, over time, damage the tiny blood vessels that act as these filters. This is known as diabetic nephropathy (or diabetic kidney disease).

When the filters are damaged, they can become “leaky”. This allows protein, which should stay in the blood, to leak into your urine. If left untreated, this damage can stop the kidneys from working properly.

How do we check for kidney damage?

Kidney damage rarely causes symptoms in the early stages, so regular testing is vital. These tests are part of your annual diabetes review at your GP surgery:

1. Urine ACR test: You will be asked to provide a urine sample (usually the first urine of the morning). This checks for albumin (a type of protein). Finding protein in the urine is often the earliest sign of kidney stress.
2. Blood test (eGFR): This measures how well your kidneys are filtering waste from your blood.

Note: It is important that you always take a urine sample to your annual diabetes review and or when asked.

What can I do to protect my kidneys?

There are several positive steps you can take to keep your kidneys healthy:

• Medication: If you have early signs of kidney damage, your GP or nurse may prescribe tablets (such as ACE inhibitors, Angiotensin II receptor blockers, or SGLT2 inhibitors). These are very effective at protecting the kidneys and slowing down any damage, even if your blood pressure is normal.
• Manage your blood pressure: High blood pressure is one of the biggest causes of kidney damage. Aim for the target set by your healthcare team (often below 140/90mmHg or 130/80mmHg if you already have kidney damage).
• Keep blood glucose levels in target: Keeping your HbA1c and home blood glucose readings within your agreed target range protects the tiny blood vessels in the kidneys.
• Stop smoking: Smoking slows down blood flow to the kidneys and increases the risk of kidney disease worsening.
• Drinking alcohol in moderation: Try to drink no more than 14 units a week, spread over different days. One unit equals a small glass of standard-strength wine, half a pint of normal-strength beer or cider, or a single measure of spirits.
• Avoiding over the counter painkillers: This includes over-the-counter aspirin and ibuprofen, which are from a group of drugs called non-steroidal anti-inflammatory drugs, or NSAIDS. It is safe to use these medicines occasionally, but take them exactly as prescribed, at the lowest dose possible and for the shortest time you need them. If you must take painkillers regularly for a condition, speak to your doctor about how to minimise the risk to your kidneys.

What is chronic kidney disease?

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