Prevention and Management of Chronic Kidney Disease

Editor’s Note: This article was written by Nour Sahib and originally appeared on our partner site Type2Diabetes.com.

Chronic kidney disease (CKD) commonly occurs in people with type 2 diabetes (T2D). In fact, about half of people with T2D have kidney problems at some point during their lives.¹

Prevention is the best method to manage CKD. This includes regular checkups and treatments to slow its progression. Here are a few ways CKD can be prevented or treated in people with T2D.

Blood sugar control

One of the best ways to prevent CKD is to control blood sugar levels. This is because diabetes can damage the kidneys' small blood vessels over time.¹

Your doctor will give you an A1C target that is suitable for you. For most people, an A1C of less than 7 percent is optimal to protect the kidneys.¹

Keeping blood pressure low

Another way to slow or prevent CKD is by reducing blood pressure. This may involve the use of antihypertensive drugs and/or lifestyle changes, such as lowering salt intake. For most people with T2D, a target blood pressure of less than 130/80 mmHg is optimal to protect the kidneys.¹

Medicines that protect the kidneys

There are 2 well-known classes of prescription drugs commonly used in people with T2D for their kidney-protective effects. These drugs also reduce blood pressure. These drugs include angiotensin-converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB).

Studies have shown that CKD can be slowed by using these drugs, independent of their effect on lowering blood pressure. This is why you may be prescribed one of these medicines but may not necessarily have high blood pressure.¹

Stopping the use of medicines harmful to kidneys

Some drugs can be harmful to the kidney. These drugs are commonly referred to as nephrotoxic drugs. You should not take these drugs if you are managing or attempting to prevent CKD. Examples of these drugs include:²

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve)
• Some strong antibiotics
• Some immunomodulators, or drugs that treat autoimmune conditions
• Select herbal products

The above is not a complete list. Speak with your doctor and pharmacist before you start a new medicine, especially if it is an over-the-counter (non-prescription) drug.

Reducing doses of current drugs

Some medicines are harmful to the kidneys only in certain doses. Depending on your kidney function, your doctor may reduce the dose of some of your T2D drugs.²

Health-promoting lifestyle habits

Your doctor may also recommend some lifestyle changes to prevent the incidence of CKD. These can include:²

• Not smoking – Nicotine smoking can increase the risk of developing CKD and may increase the rate of progression of CKD.
• Restricting protein intake – Reducing protein intake could help slow the progression of CKD. Your doctor may suggest that you work with a dietitian to assess your current and ideal protein needs.

Preventing chronic kidney disease requires a multifaceted approach that involves lifestyle and prescription drug interventions.

Have you incorporated some of these interventions in your own health journey? Share your experiences below!