Nearly 1 in 4 people with diabetes will develop diabetic kidney disease. In fact, kidney disease is one of the most common complications of diabetes but can be prevented. Diabetic kidney disease does not always lead to kidney failure and dialysis. Early diagnosis and treatment are more important to prevent kidney disease from progressing.
One of the earliest signs of kidney disease is an excess amount of protein in the urine. This can be detected using a urine microalbumin test.
People with type 2 diabetes are usually screened for the early stages of kidney disease when they are first diagnosed. People with type 1 diabetes are typically screened starting 5 years after their diagnosis. After that, people with both type 1 and type 2 diabetes are then generally screened once per year.
Symptoms are rare during the mildest stages of kidney disease. As kidney disease progresses, you may notice some warning signs, such as:
- Rise in blood pressure
- Swelling in the hands, feet or legs
- Loss of appetite
- Weight loss
- Nausea
- Tiredness
- Metallic taste in the mouth
- Waking up to visit the bathroom several times at night
If your healthcare provider observes one or more of these warning signs, he or she may recommend additional tests such as urine creatinine to evaluate your kidney function. These tests can be used to measure how quickly your kidneys filter the blood to remove potential toxins, known as the ‘glomerular filtration rate’
Kidney disease is categorized into five stages based on both the presence of protein in the urine and the glomerular filtration rate (GFR):
| Stage | GFR (mL/min) | Condition of the Kidneys |
| 1 | 90 or Higher | The kidneys function normally but the patient is at risk for kidney disease |
| 2 | 60-89 | Mild decline in kidney function |
| 3 | 30-59 | Moderate decline in kidney function |
| 4 | 15-29 | Severe decline in kidney function |
| 5 | 14 or lower | Kidney failure (end-stage) |
During the earliest stages of kidney disease, you can protect your kidneys and health, in general, by:
- Keeping your blood glucose levels at target
- Stop smoking
- Controlling your blood pressure and cholesterol levels with lifestyle changes or medication
- Exercising and eating a healthy diet
- Reducing your salt intake. Be sure to read food labels, even for foods that aren’t considered very salty!
During later stages of kidney disease, work closely with your healthcare provider to:
- Adjust insulin doses. As kidney function worsens, you will likely need less insulin in the latest stages.
- Reduce the doses of some of your oral medications, especially metformin and sulfonylureas
- Avoid drugs that may harm your kidneys, such as aspirin, ibuprofen, and the contrast used in CT scans
