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Diabetic Kidney Problems
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Kidneys Urinary System

Diabetic Kidney Problems

High blood sugar levels from diabetes can lead to kidney damage, a condition known as diabetic nephropathy that requires regular screening and management.

Overview

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your kidneys. Your kidneys clean your blood; if they are damaged, waste and fluids build up in your blood instead of leaving your body.

Diagnosis and Screening

Kidney damage from diabetes is called diabetic nephropathy. It begins long before you have symptoms. People with diabetes should get regular screenings for kidney disease, which include:

  • A urine test to detect protein in your urine
  • A blood test to show how well your kidneys are working

Treatment and Management

If the damage continues, your kidneys could fail. In fact, diabetes is the most common cause of kidney failure in the United States. People with kidney failure need either dialysis or a kidney transplant.

You can slow down kidney damage or keep it from getting worse by:

  • Controlling your blood sugar
  • Controlling your blood pressure
  • Taking your medicines
  • Not eating too much protein

Frequently Asked Questions

For people with Type 1 diabetes, screening for kidney disease should begin five years after diagnosis. For those with Type 2 diabetes, screening should start at the time of diagnosis because many individuals have had undiagnosed diabetes for years prior. Once screening begins, it should be performed at least annually, or more frequently if protein levels in the urine are elevated or kidney function is declining.
Microalbumin in the urine indicates that the tiny filters in your kidneys (glomeruli) are becoming leaky, which is an early sign of diabetic nephropathy. However, it is not always permanent; transient proteinuria can occur during fever, intense exercise, or acute illness. If microalbumin is detected, your doctor will likely repeat the test to confirm the finding. If confirmed, aggressive management of blood sugar and blood pressure can sometimes stabilize or even slightly improve kidney function, preventing progression to overt nephropathy.
Dietary protein restriction is generally not recommended in the early stages of diabetic kidney disease unless you have advanced kidney failure. Excessive protein can increase the workload on the kidneys, but severe restriction can lead to muscle wasting and malnutrition. Most guidelines suggest a moderate protein intake (0.8 grams per kilogram of body weight per day) for those with established kidney disease, but you should consult a renal dietitian for personalized advice rather than drastically cutting protein on your own.
While blood pressure control is one of the most effective ways to slow the progression of diabetic kidney disease, it is not a substitute for glycemic control. High blood pressure accelerates damage to the kidney filters, and high blood sugar causes direct toxic effects. Ideally, both need to be managed simultaneously. If blood sugar is difficult to control, your healthcare team may adjust your medication regimen to include agents that have both glucose-lowering and kidney-protective effects, such as SGLT2 inhibitors or GLP-1 receptor agonists, in addition to blood pressure medications like ACE inhibitors or ARBs.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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