Kidney health 101

Our kidneys have four main functions:

1. Clean the blood.
2. Process excess fluid and unwanted chemicals
3. Regulate blood pressure (BP)
4. Manage vitamin D production.

Having diabetes can increase your risk of kidney disease, so it’s important to keep your kidneys in tip top condition to help prevent problems.

You can take a risk test for kidney disease here: kidney.org.au/kidneyrisktest/.

Knowing your risk factors can keep you alert to the importance of regular screening tests, which can help detect kidney disease early, prevent further damage, and improve health outcomes.

Testing for kidney health and function can be done by simple blood and urine tests, which your GP can order. When you have diabetes, these tests should be done at least once every year.

Kidney disease in diabetes can be called nephropathy, diabetic kidney disease (DKD) or chronic kidney disease (CKD).

There are five stages of CKD and the treatment options depend on the type and stage of disease:

• During the early stages (1-2), there may be few, if any, obvious signs that there are problems. At this time, it’s important to review your medications with your doctor to make sure you’re not taking any medicines that could affect your
  kidney health and function.
• During the middle stages (3-4), people may start to feel unwell and become aware that their kidneys aren’t working as well.For example, there may be changes in how often they urinate, and their blood pressure may increase.
• In the later stages (4-5), kidney disease becomes kidney failure and people will need dialysis or maybe even a kidney transplant.

Dialysis

When your kidneys aren’t working well, they’re no longer able to filter waste or remove excess fluid from the body. This is when dialysis may be needed.

Two types of dialysis can be used: peritoneal dialysis (PD), which is done at home every night while you sleep, or haemodialysis, which is done 3-5 times each week during the day in a specialist clinic. You can discuss which way best suits you with your healthcare team.

During peritoneal dialysis, a cleaning fluid called dialysate, is circulated through a tube into the peritoneum which is part of the abdomen. This special fluid absorbs waste products, which are then taken out of the body and discarded through another tube. The dialysate fluid contains water, glucose, and electrolytes in a special balance to meet each person’s needs.

Haemodialysis is a procedure where a dialysis machine uses a special filter to clean the blood to remove waste products and fluid through tubes that go into veins.

The processes of peritoneal dialysis and haemodialysis can affect blood glucose levels, so it’s important to monitor blood glucose levels as recommended by your diabetes health professional.

Some of the medicines used to treat diabetes are normally broken down and removed by the kidneys, so if kidney function is reduced, these medicines might work differently. Your doctor may need to change the type or dose of medicine you take. Insulin is a very safe diabetes treatment for people with CKD.

Transplant

A kidney transplant is a treatment option for end-stage kidney disease and can help people feel better and live longer without the need for dialysis. In Australia, kidney transplants have a high success rate; over 94 per cent of transplants are still found to be successful one year later.

Emotional health

If you’ve been diagnosed with kidney disease, it’s normal to feel overwhelmed and scared, especially if you need dialysis or a kidney transplant. Make sure you get as much support as possible from nurses, doctors and other people who have been through it.

There are also kidney support groups (‘Kidney Clubs’) who meet either in person or online to connect people with others going through similar experiences. To find out more, visit: https://kidney.org.au/

It’s important to keep your kidneys healthy so they can perform the essential tasks they need to do throughout your life. You can do this by eating a healthy diet, keeping glucose levels in target, being active, not smoking, and reducing your salt and alcohol intake. Keeping your blood pressure in range is also very important as this can help to prevent kidney damage and medication may be required to help with this.

For more information: kidney.org.au/ways-we-help/support-groups

For NDSS fact sheets on topics including: Diabetes-related complications; Your diabetes annual cycle of care; Looking after your kidneys: ndss.com.au/about-diabetes/resources/management-resources/

Helpline contact info 1800 637 700