Diabetic kidney disease: what to know

 

Diabetic kidney disease, also known as diabetic nephropathy, occurs when high blood sugar over time damages the kidneys’ tiny filtering units. It is the leading cause of kidney failure, and approximately 1 in 3 adults with diabetes develops kidney disease. Because early kidney disease often has no symptoms, one of the most important steps you can take is to ask your healthcare provider about annual kidney screening. This includes a urine albumin-to-creatinine ratio (UACR) test and a blood test to estimate kidney function (eGFR).

At The Liver Hope Foundation, we provide education and support for people working to protect both their kidney and liver health. We are not a medical provider, so please speak with your healthcare provider about diagnosis, testing, and treatment.

 

Frequently asked questions

Learn how diabetes can affect the kidneys, which tests can find problems early, and what practical steps may help protect your kidney and liver health. This information is educational and does not replace care from your healthcare provider.

What is diabetic kidney disease?

Diabetic kidney disease is kidney damage caused by diabetes. Over time, high blood sugar can injure the blood vessels and filters in the kidneys, making it harder for them to remove waste and extra fluid from the body. It may lead to chronic kidney disease and, in some cases, kidney failure.

Why is diabetic kidney disease important?

Diabetes is the leading cause of kidney failure. About 1 in 3 adults with diabetes has kidney disease, but many people do not know it because early kidney damage often causes no symptoms. Finding it early gives you and your healthcare provider more opportunities to slow further damage.

What tests should I ask for each year?

Ask your healthcare provider about two kidney tests at least once a year: a urine albumin-to-creatinine ratio (UACR), which looks for albumin protein in the urine, and an estimated glomerular filtration rate (eGFR), a blood test that estimates how well your kidneys are filtering. Your provider may recommend testing more often based on your results and health history.

Can diabetic kidney disease be slowed?

Yes. While kidney damage may not always be reversed, timely treatment can often slow progression. Managing blood sugar and blood pressure, taking medicines as prescribed, avoiding tobacco, staying active, and following a plan tailored by your healthcare provider can help protect kidney health. Newer diabetes and kidney medicines may also be appropriate for some people.

What are warning signs of kidney problems?

Early diabetic kidney disease commonly has no symptoms. Later signs can include swelling in the legs, ankles, feet, or face; foamy urine; fatigue; rising blood pressure; and changes in how often you urinate. These symptoms can have different causes, so contact your healthcare provider for evaluation.

How are diabetes, fatty liver disease, and kidney health connected?

Type 2 diabetes is closely linked with metabolic dysfunction-associated steatotic liver disease (MASLD), formerly called fatty liver disease. Having fatty liver disease is associated with a higher risk of kidney disease. Healthy blood sugar and blood pressure, a weight goal that is right for you, regular activity, and nutritious food choices can support both organs.

Who is at risk for diabetic kidney disease?

Anyone with type 1 or type 2 diabetes can develop kidney disease. Risk rises with long-standing diabetes, high blood pressure, high blood sugar, smoking, and a family history of kidney disease. Regular testing matters even when you feel well.

How can The liver hope foundation help?

The liver hope foundation does not provide medical diagnosis, treatment, or products. We offer a free 18-page Diabetic Kidney Disease Guide in PDF and online formats, community support and outreach through our chapter network, and possible resource connections through our Social Work department. Availability of social work resources may vary. For medical care, please speak with your healthcare provider.

Take the next step for your kidney health

If you have diabetes, ask your healthcare provider about your yearly UACR urine test and eGFR blood test. Download The liver hope foundation’s free 18-page Diabetic Kidney Disease Guide for clear, practical education to help you prepare for that conversation. You can also support our nonprofit’s community education and outreach work.