Kidney Disease
Nearly 1/3 of people with type 1 diabetes develop kidney disease.
Fortunately, most people with type 1 diabetes (T1D) and kidney disease don’t end up with kidney failure.
How T1D Affects the Kidneys
The kidneys filter waste and extra water out of your blood through urine. Your kidneys also help control blood pressure and release hormones that your body needs to stay healthy. Chronic hyperglycemia (high blood sugar) can progressively or aggressively damage the kidneys, along with high blood pressure, high cholesterol, smoking and obesity. When your kidneys are damaged, they can’t filter blood like they should, which can cause waste to build up in your body.
Kidney Disease and Heart Health
Having kidney disease can increase your risk for cardiovascular complications. This happens because your kidneys are not filtering waste and water out of your blood as effectively, meaning the heart has to work harder to pump blood around the body. Complications arising from kidney disease, such as high blood pressure, can also damage blood vessels.
How to Prevent Kidney Disease
Keep your blood sugar in range
Manage blood pressure and cholesterol
Get checked annually for diabetic kidney disease by a healthcare professional
Seek preventative care early to prevent progression to advanced disease stage
Maintain a healthy weight
Tobacco-free lifestyle
Treatments for Kidney Disease
Getting early treatment is key to delaying further damage and progression of kidney disease, or diabetic nephropathy. Treatment is based on the stage of kidney disease:
In the early stages of kidney disease, medications may be prescribed to help manage blood pressure, which may also reduce the risk of kidney disease progressing. Newer glucose-lowering medications that are used to treat type 2 diabetes, such as SGLT2 inhibitors, GLP-1 receptor agonists, and mineralocorticoid receptor antagonists, also act to protect kidneys and prevent kidney disease from progressing.
Certain SGLT2 inhibitor medications are approved for and available for people with T1D to treat chronic kidney disease, which can also reduce the risk of heart-related complications. Clinical trials are underway to identify other treatments that can improve kidney health in T1D, many of which are funded by Breakthrough T1D.
As chronic kidney disease progresses to serious advanced stages, kidney dialysis or transplantation may be needed. Dialysis filters the blood, removing waste, chemicals, and extra fluid from the blood because the kidneys can’t anymore. Kidney transplant from living or deceased donors can be used to restore kidney function.
Kidney Disease FAQ
In the early stages of kidney disease, medications may be prescribed to help manage blood pressure, which can also reduce the risk of kidney disease progressing. The SGLT2 inhibitors empagliflozin and dapagliflozin are approved to treat chronic kidney disease, regardless of diabetes status. For people with T1D, these medications come with an increased risk of diabetic ketoacidosis (DKA). Consult with your healthcare provider to see if these medications may be a fit for you. As chronic kidney disease progresses to serious advanced stages, kidney dialysis or transplantation may be needed.
In its early stages, kidney disease often does not have symptoms, though foamy urine may be seen. As the disease progresses, it can cause high blood pressure, swelling in the hands and feet, a decrease in urine output, and fatigue.
Annual screening for kidney disease is recommended for people living with type 1 diabetes. Discuss screening options with your healthcare team.
Early-stage kidney disease has the potential to be reversed. End-stage kidney disease typically cannot be reversed and treatment involves slowing disease progression.
More Guidance on T1D Complications
Cardiovascular disease (CVD) is a long-term complication of type 1 diabetes. CVD includes coronary heart disease, cerebrovascular disease, and peripheral artery disease.
For people living with T1D, eye disease is a troubling reality, but early detection and timely treatment can reduce the risk of blindness by over 95 percent.
Improving Quality of Life
Breakthrough T1D is tackling the complications of T1D, including eye, kidney, and heart disease—where we have the opportunity to make short- and long-term impacts on people’s lives—strategically investing in developing treatments that can improve outcomes of T1D.
