Both type 2 and type 1 diabetes patients are at increased risk for the development of kidney disease. Most people with kidney disease have no symptoms, but your primary care doctor can perform two simple tests to check how your kidneys are working. One is a blood test (measurement of the creatinine) and the other is a urine test (measurement of the amount of albumin). Diabetic kidney disease tends to run in families. Individuals who have diabetes and a strong family history of CKD are at especially high risk, and this should serve as a signal for close monitoring for CKD.

The good news is that CKD in patients with diabetes is largely preventable. The major risk factors for CKD are poor blood glucose control, high blood pressure, elevated blood lipid levels, obesity and smoking.

Every patient with diabetes should know their A1c, which provides a measure of the average blood glucose level over the preceding three months. People who are healthy but have diabetes should have an A1c less than 6.5-7.0 percent.

Elevated blood pressure is the second most important risk factor for CKD in individuals with diabetes. The optimal blood pressure in people with diabetes is 120-130/80-85 mmHg. High blood lipid (LDL cholesterol and triglycerides) levels also represent an important risk factor for CKD.

Fortunately, we have good medications to effectively treat high blood glucose levels, high blood pressure and high lipid levels in people with diabetes. Thus, aggressive treatment of these risk factors can largely prevent CKD.

If CKD already is present, treatment can slow and even prevent further progression, depending on the stage of CKD. If not appropriately treated, the kidney damage and its associated symptoms will progress. Diabetic nephropathy represents the most common cause of end stage renal failure in the U.S. and world.

All patients with diabetes should know their A1c, blood pressure, and LDL cholesterol level. If any of these are not adequately controlled, patients should consult with a diabetes specialist about adjusting their medications. Optimal glucose, blood pressure and lipid control is essential, not only for the prevention of CKD, but also for the prevention of diabetic eye disease, heart attacks and stroke.

UT Health Physicians has a practice dedicated to keeping people with diabetes healthy.

Call 210-450-9050 to make an appointment with a diabetes specialist.

Learn more about our diabetes practice.