Written by: Peyton Hinterberger, Dietetic Intern

What is CKD?

Chronic Kidney Disease, also known as CKD, is a condition that is defined as a loss of the function of the kidneys over a period of time (1).  The kidneys are important to our bodies because they are able to filter out waste products from the blood and excrete them from the body as urine  (3). When the kidneys become damaged due to CKD, they are unable to properly filter the blood, leading to a buildup of wastes which can cause a rise in symptoms (1,2).

 

How is CKD Connected to Diabetes?

Diabetes and high blood pressure are leading causes in the development of CKD. It is estimated that CKD occurs in 20-40% of people living with diabetes (6).  In people living with diabetes, high blood sugar can put a lot of stress on the kidneys leading to damage which can increase your risk of CKD progression. High blood pressure is characterized by increases in the pressure on the walls of the blood vessels, and this can damage the vessels located in the kidneys which can also lead to CKD development (1,2).  Some signs and symptoms that patients with diabetes may experience if they are developing CKD include:

  1. Protein in the urine
  2. Abnormal glomerular filtration rate (GFR) in a routine blood test
  3. Increases in blood pressure
  4. Swelling or cramping in the legs
  5. More frequent urination
  6. A decrease in the need for insulin

 

Screening for CKD

Regular screening can detect changes to kidney function early and help slow progression. When to start screening may depend on the type of diabetes.  In people living with Type 1 diabetes, CKD may develop 10 years after diagnosis and in people living with Type 2 diabetes CKD can be present when a diagnosis is made (6). Monitoring can include annual screening for microalbuminuria, as well as glomerular filtration rate or GFR. Microalbuminuria is detected when the kidneys’ filtering abilities become damaged and protein leaks into the urine (7).  Screening for microalbuminuria can detect the early stages of kidney damage (7).  Similarly, reductions in the GFR may detect when GFR is low this also detects potential problems with kidney function. These screening measurements are great indicators of kidney function and are important markers for people living with diabetes to monitor kidney health. 

 

Lifestyle Changes for CKD and Diabetes Management

To keep your kidneys healthy and reduce the risk of CKD it is important to implement lifestyle changes to decrease the workload of your kidneys (4). The food groups that are great to include in a balanced diet for risk reduction of CKD and diabetes management include:

  1. Plenty of fruits and vegetables
  2. Healthy fats and oils
  3. Low-fat dairy
  4. Lean meats and fish
  5. Whole grains

It has also been found that high amounts of protein in the diet can impact the health of the kidneys. It is important to eat low to moderate amounts of protein during the day because when we break down protein from our diet, the products that are made and need to be removed during this process can increase the workload of the kidneys (4). Limiting your salt intake is also important because the kidneys remove excess sodium from the body, and if they are not functioning properly, this can cause a rise in sodium levels and raise blood pressure which is another risk factor for CKD (4).

 Making a Plan and Getting Support

If you have been diagnosed with CKD consider scheduling an appointment with a Registered Dietitian. They can help you implement diet changes to manage both blood sugar and blood pressure which can help decrease your risks or progression of CKD.

 

 

References:

 

[1] Facts about chronic kidney disease. National Kidney Foundation. Published May 15, 2020. https://www.kidney.org/atoz/content/about-chronic-kidney-disease

 

[2] Diabetes and chronic kidney disease. National Kidney Foundation. Published August 12, 2014. https://www.kidney.org/news/newsroom/factsheets/Diabetes-And-CKD

 

[3] Diabetic kidney disease | niddk. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease

 

[4] CDC. Diabetes & kidney disease: what to eat? Centers for Disease Control and Prevention. Published September 19, 2019. https://www.cdc.gov/diabetes/managing/eat-well/what-to-eat.html

 

[5] Ko GJ, Kalantar-Zadeh K, Goldstein-Fuchs J, Rhee CM. Dietary approaches in the management of diabetic patients with kidney disease. Nutrients. 2017;9(8):824. doi:10.3390/nu9080824

 

[6] American Diabetes Association Professional Practice Committee. 11. Chronic kidney disease and risk management: standards of medical care in diabetes—2022. Diabetes Care. 2021;45(Supplement_1):S175-S184. doi:10.2337/dc22-S011

 

[7] Microalbuminuria test. ucsfhealth.org. https://www.ucsfhealth.org/Medical Tests/003591

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