of 17 /17
American Kidney Fund reaching out giving hope improving lives Diabetes and Your Kidneys

Diabetes and Your Kidneys

Embed Size (px)

Text of Diabetes and Your Kidneys

  • 1.Americanreaching out Kidney Fund giving hope improving livesDiabetes and Your Kidneys

2. Diabetes: The #1 Cause of Kidney Failure reaching out giving hope improving lives our doctor told you that you have diabetes. You may Y have a lot of questions. This guide can help.You will learn:G What diabetes is G How diabetes can harm kidneys G Tests you may need G What to ask your doctor G Tips to stay healthy G Where to learn more While reading this guide, you will see words in bold. These words and their meetings can be found in the glossary starting on page 17.Even after reading this guide, you may still have questions. Write down any questions that you have on pages 26 and 27 and take this guide with you to your next doctor visit. 1 3. What is diabetes?How can diabetes hurt my kidneys? iabetes (sometimes called sugar) means that your Dbody has problems with a hormone called insulin.D iabetes is the #1 cause of kidney failure. The filters inyour kidneys are full of tiny blood vessels (calledglomeruli). High blood sugar can harm these tiny blood Insulin helps your body use the sugar you eat (also called glucose) for energy. When your body doesnt use insulinvessels. When this happens, it is called diabetic kidneydisease (or diabetic nephropathy). the way it should, too much sugar stays in your blood. Too much sugar in your blood can harm your body. Once the kidneys are harmed likethis, they cant be fixed. Ifdiabetic kidney disease is not What do my kidneys do? treated early, it can lead to kidneyfailure. Kidney failure means thatthe kidneys dont work well our kidneys clean waste and Y extra fluid from your blood. This makes up your urine (pee).enough to clean your blood. Thereis no cure for kidney failure. If youhave kidney failure, you will need They also do many other jobs thatdialysis or a kidney transplant tolive. you need in order to live. Your kidneys:The good news is that diabetic kidney disease does nothappen fast. Sometimes it takes many years. This means G Balance chemicals in your body you can help protect your kidneys. Even if your kidneys are G Help control your blood pressure already damaged, you can control your diabetes to help keep G Help keep your bones healthy them from getting worse. G Help make red blood cellsImportant!You will not be able to feel if diabetes has harmed yourkidneys. The only way to know is to be tested. Your doctorcan do a few simple tests to check how well your kidneysare working. Keep reading to learn more!23 4. What are the tests for kidney disease?our doctor can check your kidneys by doing a simple Y blood test and a urine test.Urine Test If your kidneys are damaged, they may letprotein leak into your urine. One test your doctor maysuggest checks for protein in your urine. Protein in your eGFR The estimated Glomerular Filtration Rateurine (called proteinuria) can be an early sign of kidney (eGFR) is a number based on your blood test fordisease. People with diabetes should have a urine test at creatinine. It tells how well your kidneys are working.least once a year.2Your doctor will test your blood for creatinine. Creatinine is Another type of urine test that your doctor may do tells how a waste that comes from your muscles. Your doctor will much protein is in your urine. This test is called a urine use the result from your creatinine test, your age, your sex albumin-to-creatinine ratio (UACR). and your race to calculate your eGFR.Use the chart below to see what your UACR result may Use the scale below to see what your eGFR may mean: 1mean.1 UACR resultWhat it may meanLess than 30 NormalMicroalbuminuria 30 to 300 (small amount of protein)More than 300Proteinuria Use the chart on page 24 to track your eGFR result.(large amount of protein)The eGFR is a good test, but its not for everyone.Use the chart on page 24 to track your urine test result. For example, this test may not be accurate if you are younger than 18, pregnant, very overweight or very muscular. Talk to your doctor to find out if this test is right for you. 4 5 5. How can I prevent or slow diabetic kidney disease?he steps to prevent diabetic kidney disease are the Checking Your Blood Sugar Level at Home Tsame steps needed to slow diabetic kidney disease. You will need to:To know your blood sugar level, you may need to testyour blood at home. You can do this using a blood G Control your blood sugar glucose meter (also called a glucometer). You can get a G Control your blood pressuremeter at your local drug store, hospital, clinic or online. G Control your cholesterol Your doctor can help you find a meter that is right for G Follow a diabetic diet you. G Avoid tobaccoG Be physically activeFor most meters, you use a tiny pin (called a lancet) to G Keep a healthy weightprick the side ofyour finger. Thismakes a tiny dropof blood. You put Control Your Blood Sugar the tiny drop ofblood on a test strip High blood sugar can damagethat comes with the kidneys. Keeping youryour meter. Then, blood sugar in a healthy range you put the test strip in the meter. The meter will show can help protect your kidneysa number. This is your blood sugar level. Your doctor and prevent or slow diabetic can also show you how to use your meter. kidney disease. A special diabetic diet, exercise and medicines can help you keep a healthy blood sugar level. You will need to check your blood sugar on a regular basis to know how youre doing.67 6. Ask your doctor how often you will need to check yourDate Blood TimeComments blood sugar.sugar level Example: When I should check my blood sugar: BeforeMonday101breakfast Example: 2 hours after Ate pancakesMonday192breakfast w/ syrup Also ask your doctor what your blood sugar level should be. In most cases, your blood sugar should be:2When Normal blood sugar What my blood to testfor most peoplesugar should beBefore eating 70 to 130 About 2 hours Less than 183 after eatingKeep track of your blood sugar numbers. Write down your result and when you took the test. If your number is high, also write down what you had to eat before the test. Share these numbers with your doctor at your next visit. Tell your doctor if your blood sugar is often too high or too low. If your blood sugar is low, eat a glucose tablet, raisins, Use the chart on the next page to get started. hard candy or honey. You can also drink fruit juice, milk or a sugary soda. Check your blood sugar again after 15 minutes to make sure it is not still low. Tell your doctor if this happens more than once.8 9 7. Checking Your Blood Sugar Level with Your Control Your Blood PressureDoctorHigh blood pressure can also harm your kidneys. In fact,Another test your doctor might suggest is called thehigh blood pressure is the #2 cause of kidney failure.hemoglobin A1C, or A1C for short. This is a blood testRemember, diabetes is the #1 cause. Having boththat tells how your blood sugar has been over the last 2 or diabetes and high blood pressure puts you more at risk3 months. for kidney disease and heart disease. Ask your doctor what your A1C result should be. The goalFor people with diabetes, a normal blood pressure is lessfor most people with diabetes is an A1C less than 7%.2than 130/80. 2 Ask yourdoctor how often youUse the chart on page 24should get your bloodto track your A1C result. pressure checked. If yourblood pressure is high, askyour doctor what you cando to lower it. If you have high blood pressure, your doctor mayLearn More - A diabetes educator can help you prescribe an ACE inhibitor or an ARB. These speciallearn how to control your blood sugar. Ask your types of blood pressure medicines can also help protectdoctor to refer you to a diabetes educator in youryour kidneys.area. You can also get a listing of diabetes educatorsfrom the American Association of Diabetes Educators Your doctor might also prescribe an ACE inhibitor or anat 1.800.338.3633 or www.diabeteseducator.org.ARB if you have diabetes and any signs of kidneyMedicare and many insurance companies will help disease, even if you do not have high blood pressure.pay for sessions with a diabetes educator.Ask your doctor if either an ACE inhibitor or an ARB isright for you.10 11 8. Control Your Cholesterol Follow a Diabetic Diet Having high cholesterol, especially if you have diabetes,What you eat can affect your diabetes. Ask a diabetesputs you more at risk for kidney disease, heart diseaseeducator or dietitian about:and stroke. It can also cause diabetic kidney disease toget worse faster.G What to eat G How much to eat For most people, normal cholesterol levels are:G How often to eatNormal for mostPicking healthy foods, eatingTotal cholesterol Less than 200smaller meals and eating more often can help you control yourHDL (good cholesterol)More than 40 diabetes and prevent problems.LDL (bad cholesterol) Less than 100 A dietitian or diabetes educator can help you plan yourUse the chart on page 24 to track your cholesterol results.meals and learn more about a healthy diabetic diet. Medicare and many insurance plans will even help payYour triglycerides are also important. People with highfor sessions with an expert. Check with your insurancetriglycerides are at more risk for kidney disease, heart disease to see if it will cover medical nutrition therapy (MNT).and stroke. For most people, a healthy triglyceride level isless than 150.3 To find a diabetes educator in your area, contact theIf your total cholesterol, LDL or triglycerides are high, or ifAmerican Association of Diabetes Educators atyour HDL is low, talk to your doctor. Your doctor may1.800.338.3633 or www.diabeteseducator.org. To findsuggest exercise, diet changes or medicines to help you geta dietitian in your area, contact the American Dieteticto a healthy cholesterol level.Association at 1.800.877.1600 or www.eatright.org. 12 13 9. Avoid Tobacco Keep a Healthy Weight Using tobacco (smoking or chewing) puts you more at riskKeeping a healthy weight can help you control your bloodfor kidney disease and many other health problems. If you sugar and lower your risk for kidney disease. Talk to youralready have kidney disease, using tobacco can make it getdoctor about how much you should weigh. If you areworse faster. overweight, losing just a few pounds can make a bigdifference.If you use tobacco, quitting can help lower your chances ofgetting kidney disease or help slow the disease down if youalready have it.Be Physically Active Exercise can help your body use insulin better. This makes iteasier to keep your blood sugar in check. Staying active alsohelps control your blood pressure and cholesterol. To get the most benefit, exercise for at least 30 minutes, 5days of the week. If that seems like too much, start outslow and work your way up. Look for fun activities that youenjoy. Try walking with a friend, dancing, swimming orplaying a sport. Adding just a little more activity to yourroutine can help. Be sure to talk to your doctor before starting any exerciseprogram.1415 10. How can I learn more?GlossaryThere are many resources thatACE Inhibitor: Angiotensin-Converting Enzyme Inhibitor. Acan help you learn how to controlmedicine used to treat high blood pressure. ACE inhibitorsyour diabetes and protect your can also help prevent or slow kidney damage.kidneys: ARB: Angiotensin II Receptor Blocker/Inhibitor. A medicineAmerican Association ofused to treat high blood pressure. ARBs can also helpDiabetes Educators prevent or slow kidney damage.Phone: 800.338.3633http://www.aadenet.org Blood Pressure: Your heart pumps blood through tubes called arteries and veins. The pumped blood makesAmerican Diabetes Associationpressure inside your arteries. This is called blood pressure.Phone: 800.342.2383 (800.DIABETES) When your blood pressure is checked, it tells how hard yourhttp://www.diabetes.orgheart is working to pump your blood. For people with diabetes, a normal blood pressure is less than 130/80.2Centers for Medicare and Medicaid ServicesPhone: 800.633.4227 (800.MEDICARE) Cholesterol: A waxy, fat-like substance in your blood. Yourhttp://www.medicare.govbody needs some cholesterol, but too much cholesterol can raise your risk for heart disease and kidney disease. ANational Diabetes Education Programnormal total cholesterol is less than 200.3Phone: 888.693.6337http://www.ndep.nih.govCreatinine: A type of waste in the blood that comes from using your muscles in everyday activities. Healthy kidneysNational Institute of Diabetes and Digestive clean creatinine from the blood. When your kidneys are notand Kidney Diseasesworking, creatinine can build up in your blood.Phone: 800.891.5390http://niddk.nih.gov1617 11. Diabetes: A disease that keeps the body from making orGlucometer: A small machine that you can use to testusing insulin correctly. Your body needs insulin to get your blood sugar at home.energy from sugar in the foods you eat. If your body cantmake or use insulin correctly, sugar can build up in your Glucose: The main sugar found in your blood. Your bodyblood and cause problems. turns many of the foods you eat into glucose. This is yourbodys main source of energy.Diabetes Educator: An important member of yourhealthcare team. Diabetes educators can teach you how Glucose Tablet: A small, chewable tablet made ofto better control your diabetes.glucose. If your blood sugar drops too low, you can eat aglucose tablet to help bring it back to a healthy range.Diabetic Nephropathy: The medical name for kidneydisease caused by diabetes. HDL: Also called high density lipoprotein or goodcholesterol. HDL carries cholesterol to the liver where itDialysis: A way of cleaning waste and extra fluid from thecan be removed from the blood. An HDL level of moreblood once the kidneys have failed. There are two types than 40 is good. An HDL level more than 60 is evenof dialysis: hemodialysis and peritoneal dialysis.better.3 Dietitian: An important member of your healthcare team. Hemoglobin A1C (A1C): A blood test to check how yourA dietitian can help you control your diabetes through diet blood sugar has been over the last 2 or 3 months. Mostchanges.people with diabetes should try to have an A1C less than7%.2Estimated Glomerular Filtration Rate (eGFR): Anumber based on your blood test for creatinine. It tellsInsulin: A hormone that helps your body turn the sugarhow well your kidneys are working. An eGFR less than 60 you eat into energy. In diabetes, your body either doesntfor 3 months or more may be a sign of kidney disease.1make or use insulin correctly. Glomeruli: The tiny blood vessels in your kidneys thatKidney Disease: Permanent damage to the kidneys. Thefilter your blood.most common causes are diabetes and high bloodpressure. If left untreated, kidney disease can lead tokidney failure. 1819 12. ReferencesKidney Failure: When the kidneys dont work wellenough to clean your blood. A person with kidney failurewill need dialysis or a kidney transplant to live. 1National Kidney Disease Education Program. (2008, March). Quick Reference on UACR and GFR, In Evaluating Patients withKidney Transplant: When a failed kidney is replaced by a Diabetes for Kidney Disease. Retrieved fromhealthy one. A kidney transplant can come from a livinghttp://www.nkdep.nih.gov/resources/uacr_gfr_quickreference.htmdonor or from someone who has just died. 2American Diabetes Association. (2009, January). Standards ofLDL: Also called low density lipoprotein or badMedical Care in Diabetes2009, 32 (S1), S13-S61. DOI:cholesterol. A high LDL level puts you more at risk for10.2337/dc09-S013kidney disease, heart disease and stroke. A normal LDLlevel is less than 100.3 3National Cholesterol Education Program. (2005, June). High Blood Cholesterol, What you need to know. Retrieved fromMedical Nutrition Therapy (MNT): Using nutrition toNational Heart Lung and Blood Institute website athelp control chronic conditions like diabetes, heart disease http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.pdfor kidney disease. MNT usually means working with adietitian to make healthy changes to your diet. Proteinuria: The medical name for protein in your urine.This may be an early sign of kidney disease. Triglycerides: A type of fat in the blood. Normaltriglycerides are less than 150.3 High triglycerides canraise your risk of heart disease and kidney disease. Urine Albumin-to-Creatinine Ratio (UACR): A urine testthat compares the amount of albumin (protein) to theamount of creatinine in your urine. A normal UACR is lessthan 30.12021 13. My healthcare team My medicinesDiabetes takes teamwork. Know your healthcare team. TellWhen you visit your doctors, they may ask you what medicinesyour healthcare team members about any changes in youryou are taking. Your doctors need to know this, because somehealth. The following table can help you keep track of your medicines should not be taken with others. Some medicinesdoctors and appointments. can also harm your kidneys. Use this chart to keep track of yourmedicines. Include any over-the-counter medicines andType of NamePhoneNextsupplements you are taking.doctornumber appointmentWhen toPrescribingMedicationDosePrimary caretake itdoctorExample:doctorVitamin C 50mgWith breakfast Dr. Kidd KneeDiabeteseducator DietitianPharmacist Nephrologist(kidney doctor)Take your medicines how yourdoctors prescribe, even if you feelfine. 2223 14. My lab results My questionsKnowing your numbers can help you stay healthy. See howThese are some questions that you mayyour numbers compare to the normal results in the chartwant to ask your doctor at your next visit.below. If your numbers are too high or too low, talk to your Please look at all of the questions first todoctor about what you can do to control them. Also ask see which ones apply to you. There isyour doctor when you should be tested again. space on the next page for you to write in your own questions that you would like to ask your doctor at your next visit. Normal My When toQuestions about my tests:for most result test again Blood testsG Is the eGFR test right for me? eGFR (page 4)More than 60A1C (page 10)Less than 7%G When should I test my blood sugar at home?Total cholesterol (page 12) Less than 200G What should my blood sugar be when I test at home?HDL (page 12) More than 40G What should my A1C result be?LDL (page 12) Less than 100 Triglycerides (page 12) Less than 150 G How often should I check my blood pressure? Urine testsG How can I keep a healthy blood pressure? UACR (page 5)Less than 30Other tests Questions about specialists:Less than Blood pressure (page 11) Can you refer me to a diabetes educator or a dietitian?130/80G GShould I see a nephrologist (kidney specialist)?24 25 15. Questions about my medicines:GIs an ACE inhibitor or an ARB right for me?Questions about my lifestyle:G What can I do to control my cholesterol levels?G How can I get help to stop using tobacco?G Am I healthy enough to start an exercise program?G How much should I weigh?Additional Questions: 2627 16. Notes: Where to Find More Help o learn more, visit our website at T www.kidneyfund.org. If you still have questions, call the American Kidney Funds toll-free HelpLine at 1.866.300.2900 or e-mail us at [email protected] Copyright 2010 by American Kidney Fund, Inc. All rights reserved. No part of this brochure may be reproduced or transmitted in any form without written permission from American Kidney Fund, Inc. 28 17. American Kidney Fund 6110 Executive Boulevard Suite 1010 Rockville, MD 20852 Phone: 301.881.3052 Fax: 301.881.0898 Toll-Free: 800.638.8299 HelpLine: 866.300.2900 [email protected] http://www.kidneyfund.orgCombined Federal Campaign #11404