About 1 in 3 adults with diabetes develops some degree of kidney disease. Persistently high blood sugar slowly damages the kidney's delicate filters — a condition called diabetic kidney disease (or diabetic nephropathy). The earlier it is found, the more can be done to protect your kidneys.
How diabetes harms the kidneys
Excess glucose in the blood damages the tiny filtering vessels of the kidney and the fine structures that clean your blood. Over years, the filters become leaky and scarred. The first measurable sign is usually small amounts of protein (albumin) appearing in the urine.
Why the urine test matters
A simple urine albumin test can detect kidney damage years before symptoms appear — when treatment is most effective. Everyone with diabetes should be screened at least once a year.
Know your numbers
| Test | What it checks | General target* |
|---|---|---|
| HbA1c | Average blood sugar over ~3 months | Around 7% (individualised) |
| Blood pressure | Pressure on kidney vessels | Below 130/80 mmHg |
| Urine ACR | Protein leaking into urine | Below 30 mg/g |
| eGFR | Kidney filtering rate | 90 or above |
*Targets are individualised — your doctor will set goals based on your age and overall health.
How diabetes affects the kidneys over time.
How to slow it down
- Control blood sugar: Keeping HbA1c near your target reduces the risk of progression.
- Control blood pressure: ACE inhibitors or ARBs both lower pressure and protect the kidney filters.
- Newer protective medicines: Classes such as SGLT2 inhibitors have been shown to protect the kidneys in diabetes — ask your doctor whether they are right for you.
- Don't smoke: Smoking accelerates kidney and blood-vessel damage.
- Healthy diet & weight: Reduce salt, limit processed food, and stay active.
When to seek review sooner
Swelling of the legs, foamy urine, rising blood pressure, or a sudden change in how much you urinate should prompt an earlier kidney review.
References & Further Reading
- National Kidney Foundation. "Diabetes and Chronic Kidney Disease." kidney.org
- KDIGO 2022 Clinical Practice Guideline for Diabetes Management in CKD. kdigo.org
- NIDDK, National Institutes of Health. "Diabetic Kidney Disease." niddk.nih.gov
This article is for general education only and does not replace personalised medical advice. Please consult a qualified physician about managing your diabetes and kidney health.