Quick Summary
Chronic kidney disease (CKD) is exacerbated when the disease is associated with diabetes. High blood sugar levels damage the filters (glomeruli), increase the amount of inflammation, and accelerate the progression of chronic kidney disease (CKD) through kidney damage.
Since diabetes is the number one global cause of End Stage Kidney Disease (ESKD), learning how your blood sugars impact how well your kidneys function will allow you to discover any issues sooner and take measures to slow down the damage caused by your blood sugars in the long run.
My neighbour was an everyday walker, taking the same route at the same time repeatedly. One day, however, he stopped walking. When I finally asked him why he had stopped, he just shrugged and said he was always tired and that his legs felt swollen. He just thought his age was catching up with him.
Well, that wasn't accurate. His blood test showed clues to the source of the problems. He had high blood sugar (diabetes) for years and was now also starting to struggle with his kidney function.
I remember this moment because kidney problems are usually quiet; they don't announce themselves. The combination of kidney problems and diabetes can become much worse than what most people understand.
Let me break down what was happening in my neighbour's case in a coffee chat format, explaining it in non-technical language.
How does diabetes slowly damage the kidneys over time?
Kidneys work like small filters that constantly clean waste from the blood. When blood glucose remains high for long periods, it damages the tiny blood vessels in the kidneys, called capillaries.
These capillaries become thick, weak, and leaky over time. Important proteins begin to pass into the urine, signalling early kidney damage.
This protein leakage is often one of the first warning signs in people with diabetes. As damage continues, the kidneys lose their ability to properly remove waste and excess fluid.
Fluid buildup and rising blood pressure start to occur. High blood sugar quietly pushes the body toward chronic kidney disease over time.
Why does kidney disease progress faster when diabetes is present?
Diabetes brings additional challenges to the kidney and will increase the rate of kidney injury, in addition to causing kidney injury.
Every day, the kidneys are damaged or irritated by high blood sugar levels. Diabetes is typically associated with high blood pressure. The presence of high blood pressure will add burden and excessive strain to the already-damaged blood vessels.
The combined damage to the kidneys and the increased load from blood pressure can lead to kidney disease developing much more rapidly than if the conditions were not together.
Because of this, diabetes-related kidney disease generally becomes severely advanced much more rapidly and requires closer monitoring than other forms of chronic kidney disease.
What early signs often go unnoticed?
Many individuals don't experience significant pain from kidney ailments until the kidney condition grows severe enough to produce significant testing results indicating it is abnormal. However, there are also "silent" warning signs that may indicate kidney trouble is on the way:
Swelling of the feet or ankles.
Increased tiredness or fatigue.
Changes in urine patterns (increased urine production at night, decreased urine production).
Light-coloured foamy urine (which can be created by protein leaking into the urine).
Difficulty concentrating.
Often, these signs are simply overlooked as symptoms of general stress/discomfort or as reminders of a person's age. However, when diabetes exists as an underlying medical condition, many people tend not to realise how important these signs can be.
How have kidney treatments changed in recent years?
• Doctors have traditionally focused on controlling blood sugar and blood pressure to slow kidney damage in people with diabetes.
• These two factors remain essential for protecting kidney function and preventing further filtering problems.
• Newer medicines now allow doctors to directly target inflammation and scarring inside kidney tissues.
• Inflammation and fibrosis play a major role in worsening chronic kidney disease related to diabetes.
• Many patients are now prescribed Kerendia 20mg Tablet, which contains finerenone. This medicine helps reduce kidney inflammation and protects kidney tissue from long-term damage.
• It works alongside blood sugar control and healthy lifestyle habits, not as a replacement. The treatment adds an extra layer of protection for people at higher risk of kidney disease.
Why do food choices matter so much for kidney health?
A person's daily dietary choices play a major role in the strain they place on their kidneys. If the kidneys do not function properly, the strain placed by high sodium intake, highly processed foods, and excessive protein intake can overwhelm the kidneys’ ability to function normally.
The primary focus of an established Kidney Disease Diet would be:
Restricting sodium intake to reduce swelling and control blood pressure.
Restricting protein intake to maintain an appropriate protein volume.
Consuming ample amounts of fresh vegetables and fruits that are acceptable for kidney health.
Drinking lots of liquids (unless otherwise restricted).
When diabetes is present, controlling carbohydrates is just as important as controlling protein when developing a balanced Kidney Diet.
Even though Good Nutrition will not cure kidney disease, it will slow its progression, sometimes much more slowly than people believe.
What small daily habits make the biggest difference?
No extreme changes required. Just consistent ones.
1. Staying on top of blood sugar
Consistent glucose control shields the kidneys from day-to-day injury.
2. Moving the body regularly
Light aerobic activity enhances circulation, blood pressure, and insulin responsiveness.
3. Drinking enough water
Light aerobic activity enhances circulation, blood pressure, and insulin responsiveness.
4. Keeping salt low
Reduced salt intake is also associated with reduced fluid retention and lower pressure on the vessels supplying blood to the kidneys.
These strategies appear straightforward, but they contribute to long-term kidney health.
Why does early action change the entire outcome?
• Early treatment helps stabilise blood sugar levels. Blood pressure tends to improve with timely care
• Inflammation in the kidneys reduces over time with proper management. Many people live full, active lives for years without reaching kidney failure
• Doctors encourage regular kidney function tests for people with diabetes, even when no symptoms are felt. Early detection plays a major role in preventing chronic kidney disease.
• Preventing chronic kidney disease happens through many small, consistent actions over time
Final thoughts
Doesn't knowing that small daily habits can slow down the gradual development of diabetic kidney damage, as well as the fact that the relationship between blood sugar levels and diabetic kidney disease is so close, make it feel like the smartest thing to do?
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