The kidneys play an essential role in helping your body maintain homeostasis, or balance. They do this by removing waste products and excess fluids. The kidneys remove these products through urine, which is produced through a multistep process involving excretion and reabsorption.

The kidneys work by excreting toxins and drugs while reabsorbing nutrients. Additionally, the kidneys remove acid produced by the body’s cells. They also help maintain a balance of electrolytes, including:

  • sodium
  • potassium
  • calcium
  • phosphorus

The kidneys serve other purposes, as well, such as making hormones that maintain blood pressure and promote red blood cell production. The kidneys also help produce vitamin D, which is necessary for bone health.

If the kidneys don’t function properly, this can lead to serious health concerns. Kidney failure can lead to electrolyte disturbances and a buildup of toxins and excess fluid in the blood.

Additionally, kidney failure can lead to a disruption in the production of the hormones needed to maintain blood pressure and make red blood cells. This can lead to high blood pressure and anemia.

High blood sugar due to diabetes can damage the blood vessels in the kidneys. This can lead to kidney injury, which can cause hypertension, or high blood pressure. High blood pressure can then further damage the kidneys, causing a decline in kidney function by increasing pressure in the blood vessels in the kidneys.

In the United States, approximately 1 in 3 people living with either type 1 or type 2 diabetes have CKD, making the risk of developing CKD quite high. The risk is also quite high in people living with hypertension. Approximately 1 in 5 people living with hypertension have CKD.

Managing diabetes and high blood pressure can help lower the risk of developing CKD. Additionally, eating a well-balanced diet, exercising regularly, and managing stress can help lower the risk of CKD. If you smoke, talking with your doctor about ways to quit could also help reduce your risk.

The symptoms of CKD are often vague and nonspecific. Symptoms of chronic kidney disease can include changes in urination, such as increased or decreased urinary output. Additionally, gastrointestinal symptoms may occur, such as:

  • nausea
  • vomiting
  • decreased or loss of appetite

People living with CKD may also experience:

  • swelling, especially in the ankles and feet
  • fatigue
  • weakness
  • dry, itchy skin
  • muscle cramping
  • chest pain
  • shortness of breath

People living with CKD may also have hypertension or anemia.

Certain diabetes medications cannot be prescribed if you have CKD, which may make it harder to manage blood sugar levels. Additionally, CKD can lead to an increase in urea levels in the body due to decreased kidney filtration. Increased urea levels can also make it harder to manage blood sugar levels.

The kidneys produce hormones known as renin and angiotensin that help regulate blood pressure. If you have CKD, your kidneys lose the ability to properly regulate blood pressure, leading to high blood pressure.

Additionally, the kidneys typically remove waste and excess fluids from the body, which also helps regulate blood pressure. In CKD, the kidneys lose the ability to maintain fluid balance, which can in turn lead to high blood pressure.

Yes, managing blood sugar and blood pressure targets can help manage CKD. The recommended blood sugar targets are typically 80 to 130 mg/dL before meals and less than 180 mg/dL 2 hours after the start of a meal.

The recommended blood pressure target is a systolic pressure of less than 140 mm Hg and diastolic pressure of less than 90 mm Hg. Talk with your doctor about the blood sugar and blood pressure targets that are right for you.

For people living with diabetes, meeting your blood sugar goals can help manage CKD. Similarly, for people living with high blood pressure, meeting your blood pressure goal can help manage CKD, too. To manage diabetes and hypertension, it’s important to take diabetes and hypertension medications as prescribed.

Other ways to help promote kidney health include monitoring your use of over-the-counter medication. Some commonly used medications, such as ibuprofen and naproxen, can harm the kidneys if used regularly.

Dietary and lifestyle modifications can also help manage CKD. These may include working with your doctor as best you can to try:

  • developing a meal plan
  • exercising regularly
  • quitting smoking, if you smoke

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can help lower blood pressure in the kidneys and prevent protein leakage from the kidneys. People with CKD may reduce their risk of developing kidney failure requiring dialysis by taking these medications.

Dr. Avi Varma is an ABMS board certified family medicine physician and public health advocate working for a nonprofit fighting the HIV epidemic in Atlanta, Georgia. Dr. Varma is an HIV Specialist™ (AAHIVS), certified through the American Academy of HIV Medicine.