What are the preventive and therapeutic steps to maintain kidney health for diabetic patients?

To maintain kidney health and prevent the progression of diabetic kidney disease, diabetic patients must focus on good control of blood sugar and blood pressure levels, in addition to adopting healthy lifestyle habits. This includes regular follow-up with a doctor and performing necessary kidney screenings.

The Importance of Controlling Blood Sugar and Blood Pressure

Controlling blood sugar and blood pressure levels is one of the most important measures for preventing diabetic kidney disease and slowing its progression. High blood sugar levels for prolonged periods can lead to damage in the small blood vessels of the kidneys, weakening their ability to filter waste from the blood [2]. The goal for most diabetic patients is to maintain a glycated hemoglobin (A1C) level of less than 7%, but healthcare teams should be consulted to determine the optimal target for each individual case [2].

Likewise, high blood pressure plays a major role in kidney damage. The blood pressure goal for most diabetic patients should be less than 140/90 mmHg [2]. Antihypertensive medications, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), can help protect the kidneys and slow their damage in diabetic patients who suffer from high blood pressure and diabetic kidney disease [2].

Periodic Kidney Screenings

For early detection of diabetic kidney disease, it is advised to perform periodic kidney screenings. These screenings include a urine test to detect the presence of albumin (protein) in the urine, which is an early sign of kidney damage [2]. A blood test is also performed to measure the creatinine level, which is used to calculate the estimated glomerular filtration rate (eGFR) to assess how efficiently the kidneys filter the blood [1]. It is recommended to perform these tests annually for patients with type 2 diabetes, and for patients with type 1 diabetes five years after their diagnosis [2]. You can learn more about Diabetic Kidney Disease: Early Screening and Prevention of Kidney Failure (Arabic).

Healthy Lifestyle Changes

Healthy lifestyle habits contribute significantly to maintaining kidney health and controlling diabetes and blood pressure. These habits include:

• Smoking cessation: Smoking is a risk factor that increases the chances of developing kidney disease [2].
• Following a healthy diet plan: Working with a dietitian to create a meal plan suitable for diabetic patients and limiting sodium (salt) intake [2].
• Regular physical activity: Engaging in regular physical activity helps control blood sugar levels, blood pressure, and weight [2].
• Maintaining a healthy weight: Obesity increases the risk of developing kidney disease [2].
• Getting enough sleep: It is recommended to sleep for 7 to 8 hours each night [2].

Prescribed Medications

In addition to antihypertensive medications, the doctor may prescribe other medications to help control blood sugar levels and protect the kidneys. Among these medications are SGLT2 inhibitors, which were originally used to treat diabetes, and have been proven to slow the progression of kidney disease [3]. It is essential to follow the doctor's instructions, take all prescribed medications regularly, and not stop taking any medication without medical consultation [2].

Medical references

• Creatinine Test
• Diabetic Kidney Disease
• Glomerular Disease