Diabetes and kidney health
Learn how diabetes, the leading cause of kidney failure, affects the kidneys, how to spot problems early, and what steps you can take to protect your kidney health.
- Medically reviewed by
- Shahzia Lakhani
- Last updated
- January 21, 2026
What is diabetes?
Diabetes is a disease that causes your blood sugar (glucose) to be too high because your body cannot make or use insulin the way it should. Insulin is a hormone your body makes that helps turn sugar from the food you eat into energy. When your body does not use insulin the way it should, too much sugar stays in your blood.
Over time, high blood sugar can harm many parts of the body, including your kidneys.
Diabetes: The leading cause of kidney failure
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33% adults with diabetes also have chronic kidney disease (CKD)
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50% of those with type 1 diabetes will develop some level of kidney damage during their lifetime, even if symptoms are mild at first.
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• 45% of all new cases of kidney failure, also called end-stage renal disease (ESRD), are caused by diabetes
There are 3 different types of diabetes, each with a different cause
Type 1 diabetes is an autoimmune disease that causes the immune system to attack the cells that make insulin in the pancreas (the organ that helps you digest food), leaving the body unable to make insulin. Symptoms usually appear suddenly and can be intense. They often include extreme thirst and hunger, frequent urination (peeing), unexplained weight loss, fatigue, blurry vision, nausea, vomiting and stomach pain. People with type 1 diabetes need insulin every day and must carefully manage their blood sugar.
Type 2 diabetes happens when the body still makes insulin but cannot use it effectively, causing blood sugar to rise over time. Symptoms often develop slowly and may go unnoticed for years. Common signs include increased thirst or urination, fatigue, blurry vision, frequent infections, slow-healing cuts or wounds, and tingling or numbness in the hands or feet. Type 2 diabetes management focuses on lifestyle changes and medicines.
Gestational diabetes develops during pregnancy when hormonal changes make it harder for the body to use insulin. Most people have no noticeable symptoms, which is why routine screening during pregnancy is important. Blood sugar usually returns to normal after giving birth, but gestational diabetes can raise the risk of developing type 2 diabetes later in life. Follow-up testing and long-term monitoring can help lower this risk.
What is diabetic kidney disease?
Diabetic kidney disease is a type of kidney disease caused by diabetes. It develops when high blood sugar damages the tiny blood vessels in the kidneys that filter waste from your blood. Over time, these filters stop working as well, allowing waste and protein to build up in the body.
Diabetes and diabetic kidney disease are related, but they are not the same. Diabetes affects how your body uses blood sugar. Diabetic kidney disease happens when diabetes damages the kidneys. You can have diabetes without kidney disease, but diabetic kidney disease only happens in people who have diabetes. When kidneys are not working well, waste products can build up in the blood, affecting how the pancreas makes insulin, which can lead to high blood sugar or diabetes.
"Managing your diabetes isn't just about blood sugar, it's also about protecting your kidneys, heart, and long-term health." – Shahzia Lakhani, Senior Director of Clinical Education
Risk factors
If you have diabetes, you are more likely to get kidney disease if you:
- Have had diabetes for many years
- Often have high blood sugar levels
- Have obesity
- Have high cholesterol
- Have high blood pressure or heart disease
- Smoke or use tobacco (including vaping)
- Have a family history of kidney disease or diabetes
- Do not follow your diabetes eating plan every day
How will I know if I have diabetic kidney disease?
At first, you may not have any symptoms when diabetes has damaged your kidneys. Since kidney damage happens over time, there are usually no symptoms until the later stages. The only way to know if you have diabetic kidney disease is for doctors to do tests for kidney disease. Doctors use blood and urine (pee) tests to check how well your kidneys are working. An early sign of diabetic kidney disease is protein (albumin) in your urine. If you have diabetes, you should have blood (eGFR measurement) and urine tests (uACR) for kidney disease at least once a year. This will tell your doctor if you are spilling more protein in your urine overtime.
What are the symptoms of diabetic kidney disease?
Symptoms that diabetes and kidney disease share include:
- Feeling very tired
- Nausea or vomiting
- Changes in appetite
- Trouble concentrating or feeling foggy
- Swelling in the legs, ankles, or feet
- Urinating more or less than usual
Complications of diabetes
Poor circulation: While diabetes can affect many parts of the body, taking care of your feet is particularly important. Diabetes increases the risk of peripheral artery disease (PAD), a condition where narrowed arteries reduce blood flow to the legs and feet. This poor circulation makes it harder for wounds to heal. Even a small foot injury can turn into a serious infection. In severe cases, infections can lead to hospitalization or amputation. Checking your feet everyday and treating wounds early can help prevent serious problems. People with diabetes may need to see a podiatrist annually (a doctor who specializes in foot care) to monitor their foot and nail health and prevent infections.
Nerve damage in the bladder: Diabetes can damage the nerves that tell your brain when your bladder is full. If urine stays in the bladder and you do not urinate, pressure can build up and harm the kidneys.
Urinary tract infections (UTIs): People with diabetes are more likely to get UTIs because high blood sugar helps bacteria grow and can weaken the body's ability to fight infection. If UTIs are not treated, they can spread to the kidneys and cause serious problems.
When to call your doctor
If you have diabetes, it is important to pay attention to any changes in your body. The signs below can mean that your kidneys aren't working as well as they should. Talking to your doctor early on can help catch problems sooner.
Contact your doctor immediately if you have a wound on your foot, even if it seems minor, because poor circulation and nerve damage can prevent you from feeling pain, can lead to deep infections, or ulcers, and complications such as amputation. Signs such as increased redness, swelling, warmth, foul odor, drainage, or fever require professional treatment.
Also, notify your doctor if you:
- Have higher blood pressure than usual
- Need to urinate more often
- Need less insulin or diabetes medicine than before
- Have ongoing nausea or vomiting
- Have itchy skin that doesn't go away
How long does it take for diabetes to damage the kidneys?
Kidney damage from diabetes usually happens slowly, over many years. With type 1 diabetes, early kidney changes often begin a few years after diabetic kidney disease is diagnosed. It takes the same amount of time for type 2 diabetes, but many people don't know they have type 2 diabetes since symptoms may be mild, so kidney damage may already be present when type 2 diabetes is first diagnosed. With type 2 diabetes, kidney damage can start before diagnosis because symptoms may be mild. Some people already have kidney damage when they learn they have type 2 diabetes.
How do doctors treat diabetic kidney disease?
Doctors will focus on controlling your blood sugar and blood pressure first, since both directly affect your kidneys. They may adjust your diabetes medicines, adding ACE Inhibitors (blood pressure medicines), or change doses since some blood pressure medicines also help protect the kidneys. Your doctor may also recommend changes to your eating plan, such as limiting sodium (salt) and managing protein levels to reduce stress on your kidneys. A renal dietitian can help you make changes that fit your life and health needs.
Avoid over-the-counter pain relievers like ibuprofen and naproxen if you have diabetes and kidney disease, unless your doctor says they are safe. These medicines may harm your kidneys.
How can I prevent diabetes from causing kidney disease?
Your doctor will work with you to create a plan to prevent or slow damage to your kidneys. Even if your kidneys are already damaged, you can slow the damage from getting worse.
Your treatment plan may include:
- Keeping your blood sugar in a healthy range. Tell your doctor if your blood sugar is often too high or too low.
- Managing your blood pressure. Having both diabetes and high blood pressure can make you more likely to get kidney disease.
- Managing your cholesterol. Cholesterol is a waxy, fat-like substance in your blood. Having both diabetes and high cholesterol can make you more likely to get kidney disease, heart disease, and stroke.. Cholesterol is a waxy, fat-like substance in your blood. Having both diabetes and high cholesterol can make you more likely to get kidney disease.
- Taking all your prescription medicines as your doctor tells you.
- Meeting with a diabetes educator or dietitian to help you create and follow a personalized eating plan.
- Quitting smoking or using tobacco in all forms, including vaping.
- Being active at least 30 minutes a day on most days of the week. Being active helps your body use insulin better.
- Staying at a healthy weight. Ask your doctor what a healthy weight is for you.
Where can I find more support?
A diabetes educator can teach you how to control your blood sugar and care for your health. Your doctor can help you find a diabetes educator or program in your area. You can also use the American Association of Diabetes Educators online locator. Medicare and many private insurance plans will help pay for visits with a diabetes educator. Find a program near you
From symptoms and treatment, to management and medication the American Diabetes Association can offer the support you need to live well with diabetes.
Black and Hispanic people are more likely than white people to develop kidney disease and face delays in diagnosis and treatment. Learn more about Kidney Health for All and how access to health education can help all people prevent and manage kidney disease.
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