How to Help Prevent Kidney Disease When You Have Diabetes

The kidneys are vital organs responsible for waste management, which is crucial for maintaining your body’s chemical balance and blood pressure. If you don’t take good care of your kidneys, you’re risking a slew of health problems, some of which could cause these organs to shut down altogether.
Some of the most common kidney-linked diseases are kidney stones, urinary tract infections, and hypertension.
How does diabetes affect the kidneys? Kidney disease and diabetes go hand in hand — in fact, diabetes is the leading cause of kidney disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), with 1 in 3 adults with diabetes also having kidney disease. According to the Centers for Disease Control and Prevention, 37.3 million Americans have diabetes — 11.3 percent of the population — and the high blood sugar levels that go along with diabetes require the kidneys to work harder to filter out excess water and wastes.
Diabetic nephropathy is a serious kidney-related complication of type 1 diabetes and type 2 diabetes. It is also called diabetic kidney disease. Did you know that about 10 to 40 percent of people with diabetes will develop chronic kidney disease (CKD)? Early on, kidney disease with diabetes has no known symptoms. According to the Mayo Clinic, in later stages of kidney disease, the signs and symptoms include:
- Appetite loss
- Confusion of difficulty concentrating
- Fatigue
- High blood pressure
- Increased urge to urinate
- Nausea and vomiting
- Persistent itching
- Protein in the urine
- Swelling (edema) of feet, ankles, hands or eyes
What protects your kidneys when you have diabetes? The best way to prevent or delay diabetic kidney disease is to maintain a healthy lifestyle and treat your diabetes and high blood pressure. Here are some helpful tips:
- Be more active. It’s important to exercise daily and be physically active to manage your blood pressure and keep blood sugar levels in a healthy range.
- Check your blood glucose regularly. Talk to your doctor and diabetes nurse educator about a healthy blood sugar range and try to keep your levels within this goal.
- Get screened early for kidney disease. If kidney damage is found early, it can be slowed down or managed. Talk to your doctor and learn lifestyle steps you can take to have healthy kidneys.
- Quit smoking. Smoking cigarettes reduces blood flow to your kidneys, causing a decrease in function. Smoking cigarettes also increases blood sugar levels, which worsens kidney function.
- Be careful with pain relievers. Using nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve) regularly may result in kidney damage. Ask your doctor about your usage of NSAIDs and other medications and see if an alternative medicine may work in your situation.
To protect your kidneys when you have diabetes, follow these simple steps.
5 Ways to Lower Your Risk of Diabetic Kidney Disease

Next up video playing in 10 seconds
Eat Fruits and Vegetables for Healthy Kidneys

In one study, researchers noted that including more fruits and vegetables in your diet can minimize your risk for kidney injury and metabolic acidosis. This is a condition in which the body produces too much acid, can’t excrete enough acid, or can’t balance acid. An overabundance of acid can cause potentially dangerous symptoms, such as rapid breathing, fatigue, confusion, and — in extreme cases — even shock or death. Fruits and veggies help the kidneys remove excess acid from the body and excrete it in urine.
Adding more fruits and vegetables has specifically helped patients with chronic kidney disease, who are most susceptible to metabolic acidosis. These patients are usually treated with bicarbonate and other alkali supplements. But in this study, researchers at Texas A&M University College of Medicine in Temple, Texas, wanted to see the effect of simply eating more fruits and vegetables — both of which are good, natural sources of alkali.
The researchers randomly treated 71 patients who had stage 4 chronic kidney disease with either a diet including fruits and vegetables or an oral alkaline medicine. Both groups showed similar kidney function, decreased rates of metabolic acidosis, and lowered rates of kidney injury. The researchers argued in their paper that these interventions may help improve kidney health in people diagnosed with kidney disease.
But be sure to talk to your doctor about the right diet for you. Some patients with kidney disease may need to limit intake of potassium, which can be higher in certain fruits and vegetables.
Take Fish Oil to Make Dialysis Work Better

A study in Kidney International reported that omega-3 fatty acids, like those found in fish oil, may protect dialysis patients from sudden cardiac death. The researchers looked at blood levels of omega-3 fatty acids in 400 dialysis patients, 100 of whom had died within their first year of treatment. (The risk of sudden cardiac death is highest during the first year of dialysis.)
The researchers observed in their paper that, during the first year of a patient beginning hemodialysis, those participants who had higher levels of omega-3 fatty acids — which are found in fatty fish, like salmon and tuna, as well as flaxseed and walnuts — had a lower risk of sudden cardiac death. The study offered some clues for new treatments against sudden cardiac death in people with kidney disease who are undergoing dialysis.
Cut Back on Salt to Protect the Kidneys

While salt, which contains sodium, is integral to maintaining a healthy fluid balance in the body, eating too much salt can harm our kidneys, which are responsible for acting as the body’s natural filtration system. When we eat too much of this type of food, our kidneys are forced to work in overdrive to expel what we don’t need, potentially to the point of breaking down. Eating too many salty foods can also increase the risk of high blood pressure, possibly leading to heart disease and stroke, which people with diabetes are already at a greater risk of developing, notes Johns Hopkins Medicine.
As noted earlier, 1 in 3 American adults with diabetes has kidney disease, per the NIDDK, but managing diabetes well can help keep your kidneys healthy and prevent disease. In addition to eating too much salt and not following a diabetes-friendly diet, being overweight, physically inactive, and smoking are some of the factors that can increase your risk of kidney disease if you have diabetes. Having a family history of kidney failure can also be a risk factor, and people with diabetes who are Black, Hispanic, or Asian American may also be more likely to develop kidney disease or kidney failure, per the National Kidney Foundation.
Keep Kidneys Healthy With Regular Exercise

According to a research review, regular exercise benefits those living with CKD, as well as those who have undergone a kidney transplant. The review notes that people who exercised not only improved their overall physical fitness, but they also had healthier blood pressure and heart rates, as well as overall good nutrition and lifestyle profiles.
In analyzing 45 different studies with more than 1,800 participants, the researchers found that patients on dialysis, those who did not yet need dialysis, and recipients of transplants all benefited from exercise. Resistance training aided walking ability, yoga helped with muscle strength, and cardiovascular exercise improved aerobic capacity.
- Diabetic Kidney Disease. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). February 2017.
- By the Numbers: Diabetes in America. Centers for Disease Control and Prevention. October 25, 2022.
- Diabetic Nephropathy (Kidney Disease): Symptoms and Causes. Mayo Clinic. October 24, 2023.
- Goraya N, et al. A Comparison of Treating Metabolic Acidosis in CKD Stage 4 Hypertensive Kidney Disease With Fruits and Vegetables or Sodium Bicarbonate. Clinical Journal of the American Society of Nephrology. March 2013.
- Friedman AN, et al. Inverse Relationship Between Long-Chain N-3 Fatty Acids and Risk of Sudden Cardiac Death in Patients Starting Hemodialysis. Kidney International. June 2013.
- Diabetes and Heart Disease. Johns Hopkins Medicine.
- Race, Ethnicity, and Kidney Disease. National Kidney Foundation. 2020.
- Heiwe S, et al. Exercise Training for Adults With Chronic Kidney Disease. Cochrane Database of Systematic Reviews. October 5, 2011.

Kacy Church, MD
Medical Reviewer
Dr. Church always knew that she wanted to pursue endocrinology because the specialty allows for healthy change through patient empowerment. She completed her fellowship in endocrinology, diabetes, and metabolism in 2017 at Stanford University in California.
She loves running, dancing, and watching her sons play sports.
