How Diabetes Affects Your Kidneys

Diabetic kidney disease is the complication most likely to be advanced by the time anyone notices it, because most people with it have no symptoms at all.

That is the whole argument for screening. You cannot feel early kidney damage, and by the time you can, a lot of function has gone.

The two tests to ask for

• A urine test for albumin — a protein that leaks into urine when the kidney's filters are damaged. This is the early-warning test, and the one most often not done.
• A blood test of kidney function, which estimates how well your kidneys are filtering.

How often: once a year. That applies from diagnosis if you have Type 2 diabetes, and from five years after diagnosis if you have Type 1.

What slows it down

• Blood pressure control, with a usual target below 140/90 mm Hg. This matters as much as glucose here.
• ACE inhibitors or ARBs, which are prescribed specifically because they slow kidney damage in people with diabetes.
• Reaching your glucose targets.