My patient had high blood sugar but slightly elevated BP. It impacted his kidneys: Why the diabetes-BP link matters

Even a slight increase in creatinine levels can indicate that your kidneys are strained. The good news is, at this stage, it’s often reversible

High blood sugar in diabetes can damage blood vessels, leading to stiffness and narrowing that raises blood pressure. (File Photo)

One of my patients, Ramesh, looked worried during a follow-up session. “My reports say my blood pressure and creatinine levels are a bit high. Is this condition very serious? Does that mean as somebody with diabetes, everything is going out of control?” he asked. I was happy that he had approached me early. For many people living with diabetes, even a slightly higher blood pressure can end up impacting the kidneys over time. So, it is necessary to keep both your blood sugar and blood pressure under control.

Why blood sugar and blood pressure can impact the kidneys

Kidneys are like your filter. They remove waste products and retain essential products. But when your sugars are very high for a long period of time, small blood vessels in your kidneys are affected. Changes in the structure of the kidneys occur. Hence, it becomes hard for the kidneys to work. Filtration process is affected. On top of it, if the blood pressure is also high, then the same blood vessels get an extra burden. So, when diabetes and high blood pressure occur together, the kidneys are under double pressure.

Does this mean you are beginning to develop kidney disease?

Not necessarily. But you should be more careful about the early alarming signals. Even a slight increase in creatinine can indicate that your kidneys are strained. The good news is, at this stage, it’s often reversible or can be slowed down with the right care.

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Why blood sugar and blood pressure are linked

High blood sugar in diabetes can damage blood vessels, leading to stiffness and narrowing that raises blood pressure. Insulin resistance can lead to the kidneys retaining more sodium, which increases fluid volume and blood pressure.

What my patient focused on

First, he followed a healthy diet to control blood sugars and blood pressure. We made sure to keep his fasting and postprandial sugar levels under control. We focused on maintaining blood pressure around 120/80 mmHg. If this goes beyond limit despite some lifestyle adjustments, then we could give him blood pressure tablets to protect his kidneys.

What was the diet he followed?

He simply followed the healthy plate concept. I ask everybody to follow this. Fill half your plate with vegetables, one quarter with rice and other quarter with curry/dal/curd/animal protein. Reduce your salt intake. Avoid processed and fried foods and increase your intake of fresh vegetables and whole grains. Keep a focus on proteins. Make sure to have the right amount, no excess or no less. Your dietitian can help you plan your meals based on your kidney function and blood sugar levels.

Keep yourself adequately hydrated. But do not drink excessive amounts of water. Do not take over the counter (OTC) drugs unless prescribed. Make sure to check your kidney function every three months.

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What is a kidney function test?

Kidney function tests include urea, creatinine, urine PC (protein-creatinine) ratio and microalbuminuria (which measures the protein albumin in the urine). Now microalbuminuria is a test that can help detect kidney diseases much earlier. Monitor your blood sugar and blood pressure regularly. Also, try to walk at least 30 minutes daily, manage stress and sleep well.

With consistent care, lifestyle control and regular monitoring, you can protect your kidneys for years to come.

(Dr Mohan is Chairman, Dr Mohan’s Diabetes Specialities Centre, Chennai)