Diabetes can affect your kidneys even when you feel completely fine. In the early stages, kidney damage often causes no noticeable symptoms. That is why regular kidney function tests are important for people living with diabetes.
Early detection can help healthcare professionals identify kidney problems and provide appropriate care. Understanding the possible warning signs and knowing which tests to get can help you make informed decisions about your kidney health.
How Does Diabetes Affect the Kidneys?
Your kidneys filter waste and excess fluid from your blood. Over time, high blood sugar levels can damage the small blood vessels inside the kidneys, affecting their ability to filter blood properly.
This condition is known as diabetes-related kidney disease, also called diabetic kidney disease.
High blood pressure can further increase the risk of kidney damage. However, not every person with diabetes who develops kidney problems necessarily has diabetic kidney disease. Other causes may need to be investigated.
Kidney damage can develop gradually without noticeable symptoms. Some people discover a problem only through routine blood and urine tests.
Possible Signs of Kidney Problems in People With Diabetes
Early kidney disease often has no symptoms. As kidney function declines, some people may experience the following changes.
- Swelling in the Feet, Ankles or Hands
Swelling may occur when the kidneys cannot remove excess fluid effectively. You may notice puffiness around your ankles, feet, hands or face.
However, swelling can have several causes and does not necessarily indicate kidney disease. Persistent or unexplained swelling should be assessed by a healthcare professional.
- Changes in Urination
Some people may notice changes in how often they urinate, particularly at night. Unusually foamy urine can sometimes indicate excess protein in the urine.
Frequent urination can also occur when blood sugar levels are high. A urine albumin-to-creatinine ratio (UACR) test can help identify increased albumin in the urine, which may indicate kidney damage.
Changes in urination alone cannot confirm a kidney problem.
- Persistent Tiredness or Weakness
Unusual tiredness or weakness may occur in people with advanced kidney disease. Possible reasons include anaemia and the accumulation of waste products in the body.
Fatigue can also result from poorly controlled blood sugar, sleep problems and other health conditions. A healthcare professional can help identify the underlying cause.
- Poor Appetite or Nausea
Some people with advanced kidney disease may experience nausea, reduced appetite or a general feeling of being unwell.
These symptoms can have many causes and should not automatically be attributed to kidney disease. Seek medical advice if they persist or are accompanied by other concerning symptoms.
- High Blood Pressure That Is Difficult to Control
High blood pressure can contribute to kidney damage, while kidney disease can also make blood pressure more difficult to control. The two conditions can affect each other.
High blood pressure does not necessarily mean that kidney damage has occurred. However, people with diabetes should monitor their blood pressure regularly and discuss their readings with a healthcare professional.
Important: These symptoms do not confirm kidney damage, and the absence of symptoms does not rule it out. Blood and urine tests are essential for assessing kidney health.
Which Tests Can Detect Kidney Damage From Diabetes?
Two key tests help healthcare professionals assess kidney function and identify possible kidney damage in people with diabetes.
- Estimated Glomerular Filtration Rate (eGFR)
The eGFR estimates how effectively your kidneys filter waste from your blood. It is calculated using your blood creatinine level and relevant personal information.
A lower eGFR may indicate reduced kidney function. However, one abnormal result does not necessarily establish chronic kidney disease (CKD).
The eGFR is an estimate rather than a direct measurement of kidney function. Its accuracy may be affected by factors such as rapidly changing creatinine levels and unusually high or low muscle mass.
Healthcare professionals interpret eGFR alongside previous results, medical history and other test findings.
- Urine Albumin-to-Creatinine Ratio (UACR)
The UACR is a urine test that measures the amount of albumin relative to creatinine in your urine.
Albumin is a protein normally found in the blood. When the kidneys’ filtering structures are damaged, albumin may pass into the urine.
A UACR result of 30 mg/g or higher may indicate increased urine albumin. This can be an early sign of kidney damage, even when eGFR is within the expected range.
A single abnormal UACR result does not always confirm CKD. Temporary factors can affect urine albumin levels, so a healthcare professional may recommend repeat testing.
Both eGFR and UACR are important. The eGFR assesses kidney filtering function, while the UACR helps identify possible kidney damage.
What Does Chronic Kidney Disease Mean?
Chronic kidney disease is defined by abnormalities of kidney structure or function that persist for at least three months and have implications for health.
A single abnormal test result does not always establish CKD. Healthcare professionals may review previous results, repeat tests and consider other clinical findings to determine whether the problem is persistent.
Do not wait three months to seek medical advice about an abnormal result. Prompt assessment is important because some causes of reduced kidney function may require urgent attention.
When Should People With Diabetes Get Their Kidneys Checked?
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends regular kidney disease testing for people with diabetes.
Annual kidney testing is generally recommended for:
- People with Type 2 diabetes: Starting at diagnosis.
- People with Type 1 diabetes: After they have had diabetes for five years.
Testing generally includes a blood test to estimate eGFR and a urine test to check for albumin.
Your healthcare professional may recommend more frequent testing depending on your results, medical history and overall health.
Do not wait for symptoms before discussing kidney screening with your healthcare professional.
What Can Help Protect Kidney Health?
If you have diabetes, the following measures may help manage your risk of kidney complications and support your overall health.
- Manage blood sugar: Follow your personalised diabetes management plan and monitor blood glucose as advised.
- Monitor blood pressure: Check your readings regularly and follow your healthcare professional’s recommendations.
- Attend regular check-ups: Complete the recommended blood and urine tests, even if you feel well.
- Follow a balanced diet: Your dietary needs may change if you have kidney disease. Seek individual advice from a qualified healthcare professional or dietitian.
- Take medicines as prescribed: Do not stop, change or add medicines or supplements without consulting your healthcare professional.
- Discuss kidney-protective treatments: Ask your healthcare professional whether any additional treatments are appropriate for your diabetes, blood pressure and kidney health.
- Avoid smoking: Smoking increases the risk of kidney and cardiovascular complications.
- Stay physically active: Choose activities appropriate for your health and abilities.
These steps can help manage risk, but they cannot guarantee that kidney disease will be prevented. Your care plan should be based on your individual health needs and medical advice.
Frequently Asked Questions
Can diabetes damage the kidneys without causing symptoms?
Yes. Early kidney disease often causes no noticeable symptoms. Regular blood and urine tests can help detect possible kidney problems before symptoms develop.
What is the most important test for kidney damage in diabetes?
Both eGFR and UACR are important. The eGFR estimates how well the kidneys filter blood, while UACR checks for increased albumin in the urine. Together, they provide complementary information about kidney health.
Does a high creatinine level always mean kidney disease?
No. Creatinine levels can be influenced by several factors, including muscle mass, diet and certain medicines. A single result does not always establish a diagnosis. Healthcare professionals consider eGFR, urine albumin, previous results and other relevant clinical information.
Can kidney damage from diabetes be reversed?
The outcome depends on the cause and extent of the damage. Some abnormalities may improve with appropriate treatment, while established chronic kidney damage may not be fully reversible. Early assessment and ongoing medical care can help manage the condition and may reduce the risk of further damage.
How often should I get my kidneys tested if I have diabetes?
Annual kidney testing is generally recommended from diagnosis for people with Type 2 diabetes and after five years for people with Type 1 diabetes. Your healthcare professional may recommend a different schedule depending on your test results and health status.
Conclusion
Diabetes-related kidney disease can develop without obvious warning signs, making regular screening especially important.
If you have diabetes, ask your healthcare professional about your eGFR and UACR results and how often you should have your kidneys checked.
If you experience persistent swelling, changes in urination, unusual fatigue or other concerning symptoms, seek medical advice rather than trying to diagnose the cause yourself.
Looking after your kidney health starts with awareness, appropriate testing and timely medical care.
Medical Disclaimer
This article is intended for general educational purposes only and is not a substitute for individual medical advice, diagnosis or treatment. Consult a qualified healthcare professional about your symptoms, test results and treatment options.