Chronic Kidney Disease and Diabetes: Understanding Your Risk

Learn how diabetes increases the risk of chronic kidney disease, the warning signs, and how to protect your kidney health.

By Sneha Tete, Integrated MA, Certified Relationship Coach

Created on Sep 25, 2025

Learn how diabetes increases the risk of chronic kidney disease, the warning signs, and how to protect your kidney health.

Kidney disease is a significant, yet often under-recognized, complication of diabetes. Particularly with type 1 and type 2 diabetes, the risk of developing chronic kidney disease (CKD) increases over time, potentially leading to severe health concerns if not properly managed. This comprehensive guide explores how diabetes impacts kidney health, key warning signs, steps for prevention, and crucial answers for concerned individuals.

How Diabetes Affects Your Kidneys

Diabetes is a leading cause of chronic kidney disease. It impairs the body’s ability to process glucose (blood sugar), leading to persistently high blood glucose levels. Over months and years, this excess glucose can cause damage to the tiny blood vessels and filtering units (nephrons) within the kidneys.

When these filters are damaged, the kidneys cannot efficiently remove waste and excess fluids, which can lead to the gradual progression of diabetic kidney disease, also known as diabetic nephropathy. This condition evolves slowly, often over many years, and is accelerated by poor management of blood sugar or blood pressure.

High blood sugar levels cause direct injury to kidney cells, impairing filtration.
High blood pressure frequently accompanies diabetes and further strains the kidneys.
Family history of kidney disease elevates the risk for diabetics.

Why Are People with Diabetes at High Risk?

Kidneys act like powerful filters, removing waste products and excess water to maintain a chemical balance in the blood. Diabetes-related complications, particularly poor glucose control and elevated blood pressure, strain this delicate system. Over time, the filtering units become unable to function optimally, causing waste to build up in the body and proteins to leak into the urine (a process known as microalbuminuria).

According to health authorities, as many as 1 in 3 adults with diabetes develop CKD during their lives. Diabetes is now recognized as the top cause of chronic kidney disease worldwide.

Symptoms of Diabetic Kidney Disease

One of the most challenging aspects of CKD is its silent progression. Many individuals experience no symptoms in the early stages; signs often become noticeable only once substantial kidney damage has occurred. Watch for these key warning indicators:

Fluid retention, resulting in swollen legs, feet, or hands
Foamy urine, indicating protein leakage
Fatigue, weakness, or decreased energy
Nausea or vomiting
Loss of appetite or weight loss for no obvious cause
Changes in urination (frequency, volume, or appearance)
Difficulty concentrating
Itchiness or dry skin
Trouble sleeping

If you notice these symptoms, especially if you have diabetes, early medical evaluation is crucial.

Diagnosis: How Is Diabetic Kidney Disease Detected?

Early detection of kidney complications in diabetes relies on regular screening and testing. Most commonly, doctors check for:

Urine protein tests (albumin/creatinine ratio) to detect albumin leakage
Blood creatinine levels to estimate glomerular filtration rate (eGFR), a measure of kidney function
Blood pressure evaluations

Screening recommendations:

People with type 1 diabetes: annual urine and blood tests starting 5 years after diagnosis
People with type 2 diabetes: annual screening starting at diagnosis

Stages of Chronic Kidney Disease

CKD is categorized into stages based on the glomerular filtration rate (eGFR). Lower eGFR values correspond to more advanced kidney damage:

Stage	eGFR (mL/min/1.73m²)	Description
1	90 or above	Normal or high function, with some signs of damage
2	60–89	Mild reduction in kidney function
3a	45–59	Mild-to-moderate reduction
3b	30–44	Moderate-to-severe reduction
4	15–29	Severe reduction
5	<15	Kidney failure (end-stage renal disease)

Early identification in stages 1–3 is crucial to slow or prevent progression.

Complications of Diabetic Kidney Disease

If CKD progresses without intervention, several serious complications can emerge, including:

End-stage renal disease (ESRD): Kidneys lose almost all ability to function; dialysis or a kidney transplant becomes necessary.
Cardiovascular disease: Risk of heart attack, stroke, and peripheral vascular disease increases considerably.
High blood pressure: Both a cause and complication of CKD, making disease management more difficult.
Anemia: Low red blood cell count due to reduced production of erythropoietin by damaged kidneys.
Bone and mineral disorders: Imbalances in calcium and phosphorus levels can weaken bones.
Nerve damage (neuropathy): Waste buildup can harm nerve fibers.

What Increases Your Risk?

While not everyone with diabetes will develop kidney disease, certain factors further increase susceptibility:

Poorly controlled blood sugar over long periods
Poorly controlled blood pressure (hypertension)
Genetic predisposition or family history of kidney disease
Other existing kidney conditions or urinary tract issues
Smoking or use of substances that strain kidney function
Frequent use of NSAIDs or certain medications harmful to kidneys

How to Reduce the Risk of Kidney Disease with Diabetes

The risk of developing diabetic kidney disease can be substantially reduced—and progression slowed—with the following strategies:

Control blood sugar: Follow your diabetes care plan closely, regularly monitor glucose, and adhere to medications or insulin as prescribed.
Maintain healthy blood pressure: Target < 130/80 mmHg unless your healthcare team advises otherwise. Use antihypertensive medications if recommended, especially ACE inhibitors or ARBs, which protect the kidneys.
Eat a balanced, kidney-friendly diet: Emphasize vegetables, fruits, lean proteins, and whole grains. Watch sodium, potassium, and protein levels if advised by your doctor.
Limit alcohol and avoid tobacco: Both can worsen blood pressure and kidney function.
Exercise regularly: Aim for at least 150 minutes of moderate activity each week.
Stay hydrated, but avoid overhydration: Too much water can stress damaged kidneys; follow your provider’s advice.
Annual kidney screening: Especially important for those with diabetes or high blood pressure.

Treatment and Management Options

Though chronic kidney disease cannot be fully reversed, its progression can be slowed dramatically with coordinated care. A multidisciplinary approach delivers the best outcomes for people living with both conditions.

Blood sugar and blood pressure management: Continue medications and healthy lifestyle measures.
Kidney-protective medications: ACE inhibitors and ARBs are commonly prescribed for diabetic kidney disease—even if you have normal blood pressure because they limit proteinuria and prevent further kidney damage.
Dietary adjustments: Reduce salt, manage protein intake, limit processed foods, and consult a dietitian familiar with renal diets.
Monitoring and treating complications: Address anemia, bone mineral imbalances, and cardiovascular risks proactively.
Dialysis or transplantation: Necessary for end-stage kidney disease when kidneys fail to work adequately.

Partnering with a care team—including nephrologists, diabetes specialists, nurse educators, and dietitians—maximizes the chances of preserving kidney function and quality of life.

Frequently Asked Questions (FAQs)

How long does it take for diabetes to damage my kidneys?

The timeline varies, but kidney damage can begin within 2–5 years after a diabetes diagnosis, especially without optimal management. Regular kidney function testing is recommended at least annually for people with diabetes.

What is the first sign of diabetic kidney disease?

Most individuals have no early symptoms. The first clinical sign is often protein in the urine (microalbuminuria), but some people notice swelling in the ankles, feet, or hands (fluid retention) and foamy urine as early symptoms.

Can diabetic kidney damage be reversed?

While existing damage cannot be reversed, proper management of blood sugar, blood pressure, and other risk factors can halt or even slow further progression.

How does diabetes cause kidney failure?

Persistently high blood glucose damages the filtering units in your kidneys. Over time, as these units fail, your ability to filter waste declines, potentially leading to end-stage kidney disease or total kidney failure.

Can insulin harm my kidneys?{
References

https://www.healthline.com/health/kidney-disease/type-1-diabetes-and-kidney-disease

https://www.uc.edu/news/articles/legacy/healthnews/2007/02/uc-health-line–multidisciplinary-team-focuses-on-preventing-diabetic-kidney-failure.html

https://www.healthline.com/health/type-2-diabetes/kidney-disease

https://www.medicalnewstoday.com/articles/172179

https://www.healthline.com/health/video/ckd-stages

https://www.healthline.com/health/video/foods-to-avoid-with-kidney-disease

https://aakp.org/programs-and-events/aakp-healthline/

https://www.youtube.com/watch?v=XUnRopZmYJs

https://globalhealth.washington.edu/news/2017/04/13/healthline-effects-kidney-disease-cardiovascular-health

https://oag.ca.gov/system/files/media/healthline-media-llc-final-judgement.pdf

Author

Sneha TeteBeauty & Lifestyle Writer

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

Read full bio of Sneha Tete