Being Kind to Your Kidneys

Tips on preventing problems.

Theresa Garnero By Theresa Garnero, APRN, BC-ADM, MSN, CDE

Imagine not being able to change your vacuum cleaner bag—ever. Or how about having a broom, but not a dust pan to get rid of the debris that gets tracked into your home. Not that cleaning is fun, just necessary. After a week, the place looks a little messy, but give it a couple of years…you get the picture.

It's like that for our kidneys. When kidneys are not filtering properly, the waste can stay trapped inside our bodies and build up to dangerous levels. This article will cover basics about kidney disease and what you can do to make a difference for these vital organs.

How do kidneys work?
The two, croissant-sized organs located on either side of the spine on just below the rib cage filter upwards of 200 quarts of blood a day, returning 198 quarts of purified blood back into the system. The remaining 2 quarts include waste products and excess fluid our bodies and don't need are removed via the urination process.

What are the symptoms of kidney disease?
In the early stages, you may not realize something is wrong. Some signs and symptoms of kidney disease may include:

  • Protein in the urine
  • High blood pressure
  • Swelling in the hands, legs or feet
  • Shortness of breath
  • High levels of blood/urea/nitrogen (BUN), and creatinine in the blood
  • A metallic taste in the mouth or ammonia breath
  • Nausea and vomiting
  • Loss of appetite
  • Weakness and anemia
  • Difficulty concentrating
  • itchiness
  • Less need for insulin or antidiabetic medications (because the kidneys can't breakdown the medicines as they once could)
  • Making more or less urine than normal
  • Urine that is foamy or bubbly

How do kidneys fail?
Kidney disease doesn't happen overnight. If left undetected, it progresses slowly, often over a period of years (up to 7 years after the kidney is damaged). With uncontrolled diabetes, the tiny blood vessels in the kidneys responsible for filtering and cleaning the blood start to leak and are not able to function properly. In addition, consistently high blood glucose levels can damage the nerves going to the bladder. If the bladder doesn't empty completely, the urine can back up and injure the kidneys. To make matters worse, many people with diabetes are also dealing with high blood pressure, a condition that puts further stress on the kidneys.

How do I protect my kidneys?
One of the ways to reduce risks is by optimizing diabetes and blood pressure control, and to know your kidney health. At least annually, check recommended laboratory tests for blood (BUN/creatinine) and urine (microalbumin/creatinine or 24 hour urine collection for creatinine clearance). Blood pressure should be checked at each visit with your healthcare provider. Better yet, do you own a home blood pressure monitor? The recommended goal is 130/80 and below. An ACE inhibitor is a type of medication that controls blood pressure and helps to prolong kidney function. Talk with your pharmacist about medicines that may damage the kidneys (over-the-counter pain medicines are notoriously hard on weak kidneys).

How is kidney disease treated?
Get the expert to help you figure this out: a nephrologist (kidney specialist) and a registered dietitian/certified diabetes educator. Research suggests that a low-protein diet, and lowering potassium, phosphorous, and sodium in your food choices can help manage kidney disease for people with diabetes. Medications such as ACE inhibitors can also help.

Dialysis is the treatment of choice to maintain life when kidneys only function at 15% or less. Kidney transplantation is another option.

How many people have kidney disease?
Roughly 1 in 9 U.S. adults have chronic kidney disease. About 30% of people with diabetes eventually will suffer from severe kidney problems. Diabetes is the cause for approximately 43% of all new cases of diabetic nephropathy (or kidney disease). The key here is early detection and treatment when it is still possible to slow down or even reverse kidney problems.

After filtering through all these statistics, I'm inspired to have a tall glass of water and break out the vacuum cleaner.

Read Theresa's bio here.

Read more of Theresa Garnero's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: July 09, 2013

All content on is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...
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