Diabetes and Hypertension as Risk Factors for Kidney Disease in Older Adults

More than 68 million Americans have high blood pressure, and 34.2 million have diabetes. Both of these diseases are leading causes of a silent killer: kidney disease.

For older adults, the risk is especially critical as studies show that diabetes can increase with age due to factors such as obesity, decreased activity, hypertension and insulin resistance. Because of medical advances in the treatment of diabetes, patients with the disease are living longer, thus leading to more diabetes-related complications, such as kidney disease.

Kidney disease can develop due to a number of factors such as genetics, blood sugar and blood pressure. If we are caring for a loved one with diabetes who keeps their blood pressure under control, they’ll have a better chance of avoiding kidney disease.

What are the symptoms of kidney disease?

The surprising thing about kidney disease is that it produces few symptoms until kidney function is practically gone. Actual symptoms such as fluid buildup, loss of sleep, poor appetite and an upset stomach aren’t always specific, so it can be hard to diagnose kidney disease initially. A loved one with diabetes should be advised to see their doctors regularly, so that they can be checked for:

• Blood pressure
• Protein levels in their urine 
• Waste products in their blood 
• Diabetes related complications in their organs

What causes kidney disease?

To understand kidney disease, it is important for us to first understand the function of the kidneys. After we eat proteins, our bodies digest them and then create waste. The kidneys serve as filters for getting the waste out of the blood and into the urine. Tiny blood vessels push the waste out, while larger molecules like protein and red blood cells stay in the blood.

The high levels of blood sugar created by diabetes can make the kidneys filter too much blood, which causes them to break down and filter out proteins into the urine. Overwork causes the kidneys’ filtering ability to shut down. Waste products then start to build up in the blood, which leads to end-stage renal failure (ESRD), better known as kidney failure. A person with ESRD needs to have a kidney transplant or to have the blood filtered by a dialysis machine.

How can kidney disease be prevented?

A loved one with diabetes can prevent kidney disease by keeping their blood sugar in a target range. Tight blood sugar control can reduce the risk of microalbuminuria—the leakage of protein into the urine—by one third. In people who already had this condition, the risk of the condition progressing was cut in half by controlling blood sugar. Some doctors recommend a low-protein diet to treat this condition. Such a diet can decrease protein loss in the urine and increase protein levels in the blood. However, a loved one should talk to their doctor before starting any variety of diet. 

A loved one with diabetes should also be sure to watch their blood pressure and keep it under control. Blood pressure has a dramatic effect on the rate at which the disease progresses. A mild spike in blood pressure can quickly progress kidney disease. A loved one can lower their blood pressure by: 

• Losing weight using methods recommended by a doctor
• Eating less salt
• Avoiding alcohol and tobacco
• Exercising

If these methods fail, some medications may be able to lower blood pressure. However, it is important to remember that not all blood pressure medications are equally good for people with diabetes. A loved one should consult with their doctor first to explore which medications may be right for them.

A version of this article appeared in the Private Health News