Protecting Your Kidneys

Your kidneys filter your blood through millions of tiny filters, and persistently high blood sugar can damage them. Like eye disease, this produces no symptoms until it is well advanced.

Two tests find it. A urine test measures the albumin-to-creatinine ratio, looking for small amounts of protein leaking through — the earliest detectable sign. A blood test estimates your filtration rate, or eGFR, which shows how well the kidneys are working overall.

The numbers to know: albumin-to-creatinine below 30 mg/g, and eGFR above 80. In Type 1, annual urine testing is recommended once you have had diabetes for five years or more, while kidney function is tracked from earlier.

Blood pressure matters here at least as much as blood sugar. Meeting a target below 130/80 mmHg is one of the most effective things you can do to protect your kidneys, which is why it is checked at every visit.

Two practical warnings. Regular use of common painkillers can be hard on the kidneys, so mention it if you take them most days. And tell any doctor treating you for something unrelated that you have diabetes, because some medicines and contrast scans need adjusting if kidney function is reduced.

Nephropathy was recorded in 7.1% of one Indian childhood diabetes cohort — early protein in the urine is the point at which a great deal can still be done.