Prevention and Management of Chronic Kidney Disease

Chronic kidney disease (CKD) is a common comorbidity in people with type 2 diabetes (T2D). In fact, approximately half of people with T2D have kidney complications at one point during their lives.¹

Prevention is the best method to manage CKD. This includes regular checkups and interventions 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, but 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 drugs commonly used in T2D for their kidney-protective effects. These drugs also reduce blood pressure. These drugs are angiotensin-converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB).

Studies have shown that CKD can be slowed by using these drugs, and this is independent of their effect on lowering blood pressure. This is why you may be prescribed one of these medications 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. It is recommended that these drugs be discontinued or avoided if you are managing or attempting to prevent CKD. Examples of these drugs include:²

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

The above list is not exhaustive. 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 only harmful to the kidney 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 physician may also recommend some lifestyle interventions to prevent the incidence of CKD. These can include:²

• Abstaining from 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 dietician to assess your current and ideal protein needs.

Preventing chronic kidney disease involves a multifaceted approach that involves lifestyle and pharmacological interventions.

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