EDITED BY ROSEMARY NWAEBUNI

 When you have diabetes, it is key to take care of your kidneys. They do an important job filter­ing waste and removing it from your blood. Diabetes can hurt the kidneys and cause them to stop working. It is the main cause of kidney failure.

How Diabetes Damages Kidneys

With diabetes, you have high blood sugar. Those high levels make your kidneys work extra hard to filter your blood. Over time, working that hard can damage your kidneys, causing small amounts of protein to leak into your urine.

Damage can get worse and more protein leaks into your urine. Your blood pressure can start to rise. Waste materials will build up in your blood. If you do not treat it, your kidneys will not work anymore. If your kidneys fail completely, you will need to have your blood filtered by a machine (dialysis) or have a kidney transplant.

Can You Tell If You Have Kidney Damage?

There are very few symptoms of kidney disease until your kidneys have almost stopped working. One of the earliest signs is fluid buildup. You might have swollen ankles, weight gain, or you may pee more often. You may also have a hard time sleeping or concentrating. You may not be hungry, or you may have an upset stomach. You may just feel weak.

These symptoms are not very specific. That is why it is important to see your doctor regularly for these kidney-related tests if you have diabetes.

• Blood pressure. High blood pressure can be a sign of kidney problems. You should have yours checked at every health care visit. Your doctor will tell you what levels are healthy for you.

• Blood tests. The estimated glomerular filtra­tion rate (eGFR) checks how well your kidneys are able to filter your blood.

• Urine tests. Your doctor will check for levels of protein, creatinine, and albumin. These levels can show signs of kidney damage.

Treatment for Kidney Disease

If you have diabetes and kidney damage, there are things you can do to treat it and stop it from getting worse.

Lifestyle changes. Eating healthier and getting regular exercise can improve your blood glucose, blood pressure, and cholesterol. That will affect how hard your kidneys have to work. Your doctor may suggest cutting back on protein, salt, and fat in your diet. It is also smart to watch how much alcohol you drink. If you smoke, stop.

Medicine. Drugs called ACE inhibitors and angiotensin receptor blockers (ARBs) can help control your blood pressure and slow kidney damage if you have diabetes. Be careful about taking too many painkillers. Using nonste­roidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen every day can lead to kidney damage.

Monitoring. Check your blood glucose regularly at home so you can keep your diabetes in check. You may also want to track your blood pressure so you can control it if it gets high.

How to Care for Your Kidney

Your kidneys work hard for you, day in and day out. To take good care of them, you will want to focus on these things that make a big difference.

Watch your blood pressure. If it is too high, that can put stress on your kidneys. If you are not sure what your blood pressure is, your doctor can check it. You could have high blood pressure and not know it, since it does not have any symptoms. High blood pressure is one of the top causes of kidney problems. Got diabetes? If you do, work with your doctor to keep your blood sugar levels in check. If they are not under control, that can cause problems for your kidneys over time. Along with hypertension (high blood pressure), diabetes is one of the biggest concerns for kidney health.

Take your meds. If you have any prescriptions, follow your doctor’s instructions and take them as recom­mended. Yes to food and fitness. You already know that exercise and eating right help your heart and weight. They also help your blood pressure and your blood sugar levels. And that is good for your kidneys.

Shake the salt habit. Keep sodium low: no more than 2,300 milligrams a day. Check food labels to see how much is in a serving. It might be more than you think!

Be wise about water. It is good for your kidneys for you to stay hydrated. Drinking too much water, though, backfires. (Most people don’t overdo it, though.) How much to drink? One way to check is by noticing the color of your pee. If it is pale yellow or clear, it is fine. If it is dark yellow, you might need more water.

Do you drink alcohol? If so, have no more than one drink a day for women or two a day for men or better still stay off alcohol No smoking. There are two ways that smoking is bad news for your kidneys. First, it is bad for the blood flow to your organs, including your kidneys. And if you take medicine to manage high blood pressure, smoking can affect those medications. Make it your top health priority to quit, even if it takes a couple of tries. Going smoke-free will help your whole body!

Keep up with your doctor visits. Some of the tests that your doctor does at a checkup can show you clues about how well your kidneys are working.

There’s a blood test that checks to see how well your kidneys filter. Your doctor may call this a “GFR” test ( Glomerular Filtration Rate). The result is a number: 60 or higher is in the normal range. Your doctor can also do a urine test to see if a blood protein called albumin is in your pee. It is not supposed to be there. If it is, you may get more tests to see if there is a problem with your kidneys. There could be other reasons. But if you do have a kidney problem, it is best to find out early.

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