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General treatment of diabetic kidney disease

A holistic treatment of different risk factors slows the progress of the kidney disease.

The diabetic kidney disease, albuminuria and kidney failure collectively and individually increase the risk of cardiovascular disease. Proper treatment of diabetes both reduces the risk of cardiovascular disease and slows the progress of kidney disease. When the blood sugar balance is better and the blood pressure is normal, there is less protein in your urine.

Lifestyle therapy, i.e. healthy eating, exercise and non-smoking as well as medication are mutually complementary. Minor albuminuria can be fully fixed by so-called “kidney protection medication” which reduces pressure in the glomerulus as well as the secretion of albumin into the urine.

When the first signs of impaired kidney functions are observed it is good to check the diet. A nurse can provide you with general information about nutrition with regard to prevention and treatment of the diabetic kidney disease. A nutritional therapist can give detailed instructions regarding the nutritional therapy of different stages of diabetic kidney disease.

Maintaining a good sugar balance is important to prevent or slow down kidney disease and other complications related to diabetes. The target HbA1c of a person with diabetic kidney disease is below 53 mmol/mol (7%). For the elderly, the blood sugar treatment targets are individually planned.

Of the medications used to treat type 2 diabetes, SGLT2 inhibitors and intestinal hormone products are proven to slow the progress of kidney disease.

With regard to many of the medications used to treat type 2 diabetes, it may be necessary to reduce the dose or stop taking some medications entirely, if the kidney functions are reduced.

In the case of severe kidney failure, it is often necessary to cut the insulin dose as well.

The blood pressure target level is under 130/80 mmHg. Treating high blood pressure slows the progress of kidney disease. All blood pressure medications an be used. Particularly useful are ACE inhibitors and angiotensin receptor blockers (ARBs), which can be used to protect the kidneys even if the blood pressure is not elevated. They are amost effective at reducing the secretion of protein. What’s more, Kela grants special reimbursement for the medication.

The risk of cardiovascular disease associated with diabetic kidney disease is very high. That is why the LDL cholesterol target is below 1.4 mmol/l or a minimum reduction of 50% compared to the starting point

If you smoke, it is extremely important to stop due to the higher risk of diabetic kidney disease or other related complications.

    Updated 30.9.2023