A Guide to Kidney Health With Diabetes
DiabetesType 2 Diabetes
Explore This Topic

How to Keep Your Kidneys Healthy When You Have Diabetes

How to Keep Your Kidneys Healthy When You Have Diabetes
iStock
By
Updated on April 24, 2025
by

The kidneys are vital organs responsible for waste management, which is crucial for maintaining your body’s chemical balance and blood pressure. If you don’t take care of your kidneys, you risk a slew of health problems, some of which could cause the organs to shut down altogether.

Kidney disease and diabetes go hand in hand; indeed, diabetes is the leading cause of kidney disease. About 1 in 3 adults with diabetes also have kidney disease.

 The high blood sugar levels that come with diabetes may damage the kidneys’ filtration system, making it harder for them to get rid of toxins.

Diabetic nephropathy, also called diabetic kidney disease, is a serious kidney-related complication of type 1 and type 2 diabetes. About 40 percent of people with diabetes will likely develop a form of chronic kidney disease (CKD), such as diabetic kidney disease. Early on, diabetic kidney disease has no symptoms.

The best way to prevent or delay diabetic kidney disease is to maintain healthy blood sugar and blood pressure levels via lifestyle modifications and medication under the guidance of your doctor. Two classes of diabetes medications, sodium-glucose cotransporter-2 inhibitors (SGLT2s) and glucagon-like peptide-1 receptor agonists (GLP-1s), have shown efficacy in protecting the kidneys.

 Several of these, including Jardiance and Ozempic, were approved by the U.S. Food and Drug Administration (FDA) to reduce the risk of worsening CKD, kidney failure, and cardiovascular death.

Lifestyle habits that can also help include regular exercise; checking your blood glucose to ensure your blood sugar is in a healthy range; timely screening for kidney disease; and not smoking.

Here are some additional steps you can take on your own to protect your kidneys when you have diabetes.

5 Ways to Lower Your Risk of Diabetic Kidney Disease

Diabetic nephropathy, also called diabetic kidney disease, is a common and serious complication of diabetes. In order to prevent or delay the onset, there are essential lifestyle factors to take into consideration.
5 Ways to Lower Your Risk of Diabetic Kidney Disease

Next up video playing in 10 seconds

Eat Fruits and Vegetables for Healthy Kidneys

In one frequently cited study, researchers noted that including more fruits and vegetables in your diet can minimize your risk of kidney injury and metabolic acidosis.

 This is a condition in which the body produces too much acid or can’t excrete enough acid. An overabundance of acid can cause dangerous symptoms, such as rapid breathing, fatigue, confusion, and — in extreme cases — even organ failure or death.

 Fruits and veggies help protect the kidneys by decreasing acid production.

Additional fruits and vegetables have specifically helped patients with chronic kidney disease, who are susceptible to metabolic acidosis. These patients are usually treated with bicarbonate and other alkali supplements. But in this study, researchers wanted to see what happened if participants simply ate more fruits and vegetables — both of which are good, natural sources of alkali.

The researchers randomly treated 76 patients who had stage 4 chronic kidney disease with either a diet including fruits and vegetables or oral sodium bicarbonate. Both groups showed similar kidney function, decreased rates of metabolic acidosis, and lowered rates of kidney injury. The researchers argued in their paper that these interventions may improve kidney health in people diagnosed with kidney disease.

Be sure to talk to your doctor about the right diet for you. Some patients with kidney disease may need to limit their intake of potassium, which can be higher in certain fruits and vegetables.

Eat Foods With Omega-3s to Make Dialysis Work Better

One study reported that omega-3 fatty acids, like those found in fish oil, may protect dialysis patients from sudden cardiac death.

 Researchers looked at blood levels of omega-3 fatty acids in 400 dialysis patients, 100 of whom had died within their first year of treatment. (The risk of sudden cardiac death is highest during the first year of dialysis.)

The researchers observed in their paper that, during the first year of hemodialysis, those participants who had higher levels of omega-3 fatty acids — which are found in fatty fish, like salmon and tuna, as well as flaxseed and walnuts — had a lower risk of sudden cardiac death. The study offered some clues for new treatments against sudden cardiac death in people with kidney disease who are undergoing dialysis.

Cut Back on Salt to Protect the Kidneys

While salt, which contains sodium, is integral to a healthy fluid balance in the body, too much can harm the kidneys, which act as the body’s natural filtration system. When we ingest too much sodium, our kidneys are forced to work in overdrive to expel what we don’t need, potentially to the point of breaking down. Too much salty food can also increase the risk of high blood pressure, putting you at greater risk for heart disease and stroke, which people with diabetes are already more likely to develop.

Good diabetes management can help keep your kidneys free of disease. In addition to too much sodium and a diet that’s not diabetes-friendly, smoking, overweight, and physical inactivity are some of the factors that can increase your risk of kidney disease if you have diabetes.

 A family history of chronic kidney disease can also be a risk factor, and people with diabetes who are Black, Hispanic, or Asian American may also be more likely to develop chronic kidney disease or kidney failure.

Keep Kidneys Healthy With Regular Exercise

One review of studies on the impact of various forms of exercise on CKD patients noted that exercise in general is beneficial for those with the disease.

 Researchers point out, however, that the specific benefits of different types of physical activity remain unclear. In their review of 44 studies involving more than 35,000 patients, the data suggested that nearly all forms of exercise studied “significantly improve” functional performance (another name for everyday movement patterns).

Researchers found that aerobic training reduced levels of inflammatory chemicals in the blood, enhanced functional performance, and improved cardiorespiratory fitness. Combined training, which incorporates both aerobic and resistance training, was found to “robustly improve” depression and anxiety symptoms, functional performance, and cardiorespiratory fitness. Finally, home-based, respiratory, and resistance training showed “strong evidence” of improved functional performance. While the review’s authors note that one form of exercise was not shown to be better than another, they conclude that exercise is a “potent nonpharmacological tool” to improve outcomes for people with CKD.

The Takeaway

  • The kidneys are responsible for waste management in the body, which is crucial for maintaining your body’s chemical balance and blood pressure.
  • Diabetes is the number one cause of chronic kidney disease (CKD), and 1 in 3 people who have diabetes also have CKD.
  • Healthy blood sugar and blood pressure levels are necessary to prevent CKD. Work with your doctor to make lifestyle modifications and find an effective medication regimen.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Diabetic Kidney Disease. National Institute of Diabetes and Digestive and Kidney Diseases. February 2017.
  2. Chronic Kidney Disease. Centers for Disease Control and Prevention. May 15, 2024.
  3. Diabetes-Related Nephropathy. Cleveland Clinic. September 15, 2022.
  4. Breaking Down the Benefits and Costs of Kidney-Protective Diabetes Medications. National Kidney Foundation. November 20, 2024.
  5. U.S. FDA Approves Jardiance® for the Treatment of Adults with Chronic Kidney Disease. Eli Lilly. September 22, 2023.
  6. FDA Approves Ozempic® (Semaglutide) as the Only GLP-1 RA to Reduce the Risk of Worsening Kidney Disease and Cardiovascular Death in Adults with Type 2 Diabetes and Chronic Kidney Disease. Novo Nordisk. January 28, 2025.
  7. Goraya N et al. A Comparison of Treating Metabolic Acidosis in CKD Stage 4 Hypertensive Kidney Disease with Fruits and Vegetables or Sodium Bicarbonate. Clinical Journal of the American Society of Nephrology. February 7, 2013.
  8. Metabolic Acidosis. Cleveland Clinic. November 23, 2022.
  9. Friedman AN et al. Inverse Relationship Between Long-Chain N-3 Fatty Acids and Risk of Sudden Cardiac Death in Patients Starting Hemodialysis. Kidney International. February 6, 2013.
  10. Diabetes and Heart Disease. Johns Hopkins Medicine.
  11. Risk Factors for Chronic Kidney Disease. National Kidney Foundation. February 21, 2025.
  12. Social Determinants of Health and Chronic Kidney Disease. National Kidney Foundation. January 2, 2023.
  13. Correa HL et al. The Impact of Different Exercise Modalities on Chronic Kidney Disease: An Umbrella Review of Meta-Analyses. Frontiers in Physiology. January 5, 2025.
Meet Our Experts
See Our Editorial PolicyMeet Our Health Expert Network
Anna-L-Goldman-bio

Anna L. Goldman, MD

Medical Reviewer
Castle Connolly Top Doctor

Anna L. Goldman, MD, is a board-certified endocrinologist. She teaches first year medical students at Harvard Medical School and practices general endocrinology in Boston.

Dr. Goldman attended college at Wesleyan University and then completed her residency at Icahn School of Medicine at Mount Sinai Hospital in New York City, where she was also a chief resident. She moved to Boston to do her fellowship in endocrinology at Brigham and Women's Hospital. She joined the faculty after graduation and served as the associate program director for the fellowship program for a number of years.

See full bio
Brett Spiegel, MPH

Brett Spiegel, MPH

Author
Brett Spiegel, MPH, has worked in digital health for over a decade in a variety of editorial and content leadership roles. He has held positions with numerous health tech brands including GoodRx, Teladoc, and Samsung Health. He also served as editorial director and content marketing lead for Verywell Health, editor for Everyday Health, and contributing writer for HuffPost Healthy Living.

Spiegel completed his master’s degree in public health from Hunter College in New York City. His capstone examined the benefits that interactive technology could bring to distance-learning diabetes education. He holds a bachelor's degree in communications from NYU.
See full bio
See Our Editorial PolicyMeet Our Health Expert Network