Breaking Down the Benefits and Costs of Kidney-Protective Diabetes Medications

This information is for educational purposes only. Medication costs can fluctuate. Ask a healthcare professional or pharmacist for more personalized recommendations for you. Use NKF's BuzzRX card to save 60% to 80% on most medications. 

Diabetes is the leading cause of kidney disease. Around 30 percent of people with Type 1 diabetes and 10 to 40 percent of those with Type 2 are likely to develop kidney failure. The good news? There are many medications available to help you manage your diabetes and protect your kidney function. 

Diabetes occurs when the body doesn't make enough insulin or doesn't use it well. Insulin is a hormone that controls the sugar in your blood. Without it, blood sugar levels can get too high and harm the body over time.

There are three main types of diabetes:

• Type 1 Diabetes: The pancreas doesn't make insulin. People need to take insulin shots for life.
• Type 2 Diabetes: The body makes insulin but doesn't use it properly. Some people can manage it with physical activity and a healthy diet. Many also need medication, including insulin. 
• Gestational Diabetes: A person may experience diabetes for the first time when pregnant. It is similar to type 2 diabetes. In most cases, it goes away after the baby is born.

Diabetes can damage the kidneys' blood vessels. The more damaged they become, the less able they are to do their jobs. This causes more damage over time. 

This is what happened to Joseph's mother. She had Type 2 diabetes, which caused her kidneys to fail. 

"She dealt with memory loss and a foggy brain. These diseases significantly impacted her day-to-day activities," said Joseph. "It's not just your kidneys–kidney disease and diabetes can lead to so many other issues. It was worse when she started dialysis. She zoned out a lot and was more exhausted."

Learn more about diabetes. 

Recent advances in medicine mean that people with type 2 diabetes have more choices than ever when it comes to protecting their kidney health. ACEIs, ARBs, and statins are approved for use in type 1 diabetes.

Some can be pricey, but help is available. Use NKF's BuzzRX card to save 60% to 80% on most medications. Check BuzzRX frequently since drug prices can change over time.
 

ACE inhibitors reduce blood pressure and proteinuria (protein in urine), helping protect kidney health.

"When kidneys are healthy, very little or no protein appears in the urine," said Dr. Kerry Willis. "Protein in the urine is an early sign that the kidney's filters have been damaged by disease, allowing protein to leak into the urine."

Common medication names: 

• benazepril (Lotensin)
• lisinopril (Zestril, Prinivil)
• quinapril (Accupril)
• ramipril (Altace)

There are many affordable generic ACE Inhibitors ranging from $5 to $30 a month without insurance.

ARBs lower blood pressure and reduce protein in the urine, offering kidney protection similar to ACE inhibitors.

Common medication names: 

• irbesartan (Avapro)
• losartan (Cozaar)
• olmesartan (Benicar)
• valsartan (Diovan)

Generic ARBs cost between $10 to $30 per month without insurance. 

Learn more about ARBs and ACE Inhibitors.

SGLT2 inhibitors stop the kidneys from reabsorbing sugar in the blood. The sugar is then filtered out through urine. They also help lower the pressure in the kidneys and protect them, even in people without diabetes.

Common medication names: 

• bexagliflozin (Brenzavvy)
• canagliflozin (Invokana)
• dapagliflozin (Farxiga)
• empagliflozin (Jardiance)
• ertugliflozin (Steglatro)

SGLT2 inhibitors can be expensive, ranging from a few hundred dollars to over $500 a month without insurance. Some people may qualify for assistance. Find prescription payment resources. 

Learn more about SGLT2 inhibitors. 

GLP-1 RAs may help protect the kidneys by lowering blood sugar, removing extra sodium, and reducing inflammation. They also help people lose weight. More research is needed to understand how these medications directly help the kidneys. 

Common medication names: 

• dulaglutide (Trulicity)
• exenatide (Byetta, Bydureon)
• liraglutide (Victoza, Saxenda)
• semaglutide (Rybelsus, Ozempic, Wegovy)
• tirzepatide (Mounjaro, Zepbound)

Without insurance, GLP-1 RAs can be very expensive. Some brands cost over $1,000 a month. Fortunately, some companies offer manufacturers discounts. These can significantly lower the cost. 

Learn more about GLP-RAs.

nsMRAs help the body remove extra sodium and water, protecting the kidneys' filters. This reduces stress on the kidneys and heart, lowering the risk of cardiovascular problems like heart attacks and strokes.

There is only one FDA-approved nsMRA called finerenone (Kerendia). 

Finerenone can cost between $600 and $800 per month without insurance. There is no generic version yet. However, the manufacturer offers patient savings and support programs to those who qualify.

Learn more about nsMRAs.

Statins are primarily used to lower cholesterol. They also offer protection for kidney health in people with diabetes by preventing the buildup of fatty deposits in blood vessels, allowing blood to flow more easily to the heart and kidneys.

Common medication names: 

• atorvastatin (Lipitor)
• fluvastatin (Lescol XL)
• lovastatin (Altoprev)
• pitavastatin (Livalo, Zypitamag)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)
  Generic statins cost around $10–$20 per month.

Learn more about cholesterol. 

Speak with a trained professional through NKF Cares. Call toll-free at 855.NKF.CARES (855.653.2273) or email nkfcares@kidney.org to get started.