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Protect Your Kidneys

Concern: I know that people with diabetes are at a higher risk for kidney damage. What are some things I can do to protect my kidneys?
Solution: Diabetes has become the most common single cause of kidney failure in the United States and Europe, but that doesn't mean that it has to happen to you! Here are several things you can do to prevent kidney damage:

  • Keep blood sugar in your target range. Studies have shown that this is the most effective way to prevent damage to the kidneys.
  • Maintain tight control of your blood pressure below 130/80 mmHg. Even a mild rise in blood pressure can quickly make kidney disease worsen. You can do this by eating a healthy diet, eating less salt, avoiding alcohol and tobacco, and getting regular exercise. See Diabetes: Your Concerns: Heart Disease and Diabetes.
  • Talk to your health care provider about a blood pressure drug called an ACE inhibitor. These drugs can slow kidney disease in addition to lowering blood pressure.

Use of over-the-counter pain relievers on a daily basis can damage the kidneys. Aspirin may be less likely to cause kidney damage than nonsteroidal anti-inflammatory drugs (NSAIDs) or products that contain acetaminophen. If you need to treat common aches, pains or fever, it may be best to use aspirin unless there is a reason why you shouldn't take it. Here are some drugs to avoid or to use only once in a while:

  • NSAIDs
    • Advil
    • Motrin
    • Nuprin
    • Aleve
    • Naproxen
    • Ibuprofen
  • Acetaminophen containing products
    • Tylenol
  • If you need to have a radiographic procedure (ie: X-ray, MRI) that requires the use of a contrast media (dye), discuss the pros and cons of using the dye with your doctor. Contrast media is a substance that physicians use in these procedures to help them visualize certain tissues in your body. It is possible that contrast media can contribute to kidney damage, especially if you already have kidney problems.
  • Studies have shown that people with diabetes have a much higher risk of urinary tract infections (UTIs) than those without diabetes. If UTIs are left untreated, they can lead to kidney damage. If you think you have a UTI, see your physician right away to get the proper treatment. Some symptoms of UTIs include:
    • Painful or difficult urination
    • Urgency of urination
    • Frequency of urination
  • Make sure that you visit your doctor every three months. Have blood and urine labs checked yearly to see how your kidneys are doing.


References:

  • American Diabetes Association. Diabetic Nephropathy (Position Statement). Diabetes Care.2003;26(Supp.1):S94-S98.
  • American Diabetes Associaion. Standards of medical care for patients with diabetes mellitus (Position Statement).2003;26(Supp.1):S33-S50.
  • Kidney Disease: American Diabetes Association; accessed 3/5/2003
  • Perneger et al. Risk of kidney failure associated with the use of acetaminophen, aspirin and nonsteroidal anti-inflammatory drugs. NEJM.1994;22(25).
  • Curhan GC et al. Prevention of Contrast Nephropathy. JAMA. 2003;289(5):606-608.
  • Stapleton A. Urinary tract infections in patients with diabetes. The American Journal of Medicine.2002;113(1A):80S-84S.