Diabetes and chronic kidney disease (CKD): What is their relationship?

A large percentage of patients with diabetes can develop CKD. Everything will depend on the care from the beginning of the disease.

Diabetes is a disease that occurs when the body does not produce enough insulin, a hormone that controls the amount of sugar in the blood. And when diabetes is not controlled, the level of sugar in the blood rises; which can cause problems in different organs of the body, including the kidneys. A fact that many people do not know is that, worldwide, “around 40% of patients who must start dialysis are diabetics”. This is what Edward Alberto Martínez, Baxter RCS nephrologist, comments.

About a third of people with diabetes may develop chronic kidney disease (CKD). At first the symptoms can be almost imperceptible, so it is necessary to do frequent check-ups to make a diagnosis on time. However, as days go by, a patient may begin to notice warning signs such as foamy urine, edema, uncontrolled hypertension, fatigue, decreased appetite, nausea, tiredness, anemia, and episodes of hyperglycemia.

“Hyperglycemia (high blood sugar) is toxic and harmful to the kidney, it is the main mechanism that causes damage. Since the onset of diabetes, and even silently, it affects kidney function. It affects them in various degrees or stages, stage IV already implies pre-dialysis, while stage V almost always corresponds to dialysis”, says the Baxter RCS nephrologist regarding the way in which diabetes deteriorates the kidneys.

Risk factors and treatments

When you have diabetes, there are several factors that can increase your risk of CKD. Which are? According to Dr. Martínez, the list includes: “Having poor metabolic control from the start of the disease (high blood sugar), poorly controlled hypertension (high), obesity, sedentary lifestyle, inadequate adherence to medications, not attending to medical controls, being older than 45 years, dyslipidemia, having family members with diabetes, having diabetes during pregnancy, and some previous diseases such as polycystic ovary syndrome.

The specialist assures that after the diagnosis, the patient must follow a treatment that is based on two pillars: one pharmacological and one non-pharmacological. “In the pharmacological, independent of oral medications or insulins, the fundamental thing is to maintain glycemia and blood pressure figures in normal ranges. On the other hand, the non-pharmacological includes: a proper diet, regular physical activity, stopping smoking, losing weight and having adequate education about diabetes and CKD”.

It should be clear that not all diabetics end up with kidney damage. Everything depends on care from the beginning of the disease. Well-controlled patients may have no or only minimal kidney damage over time. In contrast, poorly controlled patients may have progressive damage over the years and eventually need dialysis.

Now, what can people with diabetes do to prevent CKD? The expert's recommendations are as follows:

• Keep sugar levels under control.
• Controlled pressure levels.
• Perform regular physical activity, at least every other day.
• Stop smoking.
• Lose weight.
• A balanced diet, low in carbohydrates.
• Low sodium diet (low salt).
• Periodically attend medical check-ups.
• Have an education or information about the disease.
• Have adherence to drugs.
• Avoid or minimize intake of some medications such as NSAIDs (non-steroidal anti-inflammatory drugs).

How can diabetes be prevented?

Good habits will always keep bodies healthy. And in the case of diabetes, to avoid it you have to:

• Maintain a healthy weight and avoid obesity. (Abdominal obesity is also harmful.)
• Have a healthy eating plan.
• Do exercises regularly.
• No Smoking.
• Consult the doctor in time to review some risk factors.
• Educate children to eat well and be physically active.