If you have diabetes, it's important to have your kidney function tested at least once a year. There are two ways to test for kidney disease: a blood test and a urine test.Read on to learn about each of these tests, when they're recommended and more about diabetic kidney disease.
What is kidney disease?
The kidneys are the waste strainers in our bodies.They filter out the waste from our blood and keep the useful substances, like protein and red blood cells, in your body. Normally, you are born with two kidneys, which also help make red blood cells, regulate blood pressure and help balance fluid and minerals in your body.
Diabetes is the leading cause of chronic kidney disease, with about one-third of all people with diabetes developing some stage of kidney disease.When kidney disease is caused by diabetes, it is called diabetic kidney disease (DKD) and it affects both kidneys at the same time.
DKD occurs when the kidneys start to lose their filtering ability and they allow some of the good substances, like protein, to pass out of the body as waste in the urine.That's why one of the first signs of kidney damage is protein in your urine.
Poorly-managed diabetes leads to higher blood sugar, which can damage blood vessels throughout the body, including those in the kidneys.When the blood vessels are damaged in the kidneys, it damages the organs' ability to filter properly.
Screening for kidney disease: the urine test
Your doctor can do a urinary albumin test to see if very small amounts of protein, called microalbuminuria, are present in your urine. For this test, you need to provide a small urine sample. The American Diabetes Association (ADA) recommends the following:
- If you have type 2 diabetes, you should have this test done at least once a year.
- If you have type 1 diabetes you should have this test done at least once a year, starting five years after you were diagnosed.
Your doctor may recommend screenings more frequent screenings.
Screening for kidney disease: the blood test
The ADA recommends all adults with diabetes have a blood test at least once a year to check your creatinine levels. Creatinine is a waste product. When kidneys are damaged, they will have trouble filtering creatinine from the blood. The test is a blood draw, typically taken from a vein in your arm, and is analyzed in a lab.
If you already have kidney disease, the blood test will help determine your glomerular filtration rate, or GFR.Your GFR will factor in your age, sex and race and will determine the severity of your kidney disease.Your doctor will draw some blood, most likely from your arm, and will check your blood for creatinine.
What does my GFR mean?
There are five stages of kidney disease. Your GFR tells what stage of kidney disease you have.
- Stage 1: GFR = 90+ (Kidney damage with a normal or increased GFR)
- Stage 2: GFR = 60-89 (Kidney damage with mild decrease in GFR)
- Stage 3: GFR = 30-59 (Moderate decrease in GFR)
- Stage 4: GFR = 15-29 (Severe reduction in GFR)
- Stage 5: GFR = Less than 15 (Kidney failure)
Stages 4 and 5 may require dialysis or a kidney transplant. Kidney failure occurs when the kidneys have lost their filtering ability and waste builds up in the blood. There are only two treatment options: dialysis or a kidney transplant.
As a person with diabetes, it's especially important to prevent complications from the disease.Here are the best ways to help prevent DKD.
- Control your blood sugar levels.
- Keep your blood pressure under control and check it as often as your doctor recommends.
- Ask for a urine protein test at least once a year.
- Ask for a blood creatinine test once a year if you have type 2 diabetes and once a year starting five years after your diagnosis if you have type 1 diabetes.
- Take medicines to control your blood glucose, cholesterol and blood pressure, if prescribed any by your doctor.
- Follow a diabetes-healthy diet and get regular exercise. Check with your doctor before increasing your activity levels.
- Avoid alcohol and don't smoke.
Created on 12/29/2011
Updated on 01/02/2012
- American Diabetes Association. Kidney disease (nephropathy).
- National Diabetes Information Clearinghouse. Prevent diabetes problems: Keep your kidneys healthy.
- National Kidney Foundation. Diabetes and chronic kidney disease.
- American Diabetes Association. Standards of medical care in diabetes - 2011.