When blood glucose remains elevated over time, it can damage the tiny blood vessels and filtering structures inside the kidneys. This damage may develop gradually, often without obvious symptoms.
Good diabetes management, appropriate blood pressure control, and recommended kidney screening can help reduce the risk of progression.
People with diabetes should ask their healthcare professional how often they need urine albumin testing and blood tests for kidney function.
People with high blood pressure
Persistently elevated blood pressure can damage the kidney's blood vessels and filtering units.
The risk increases when hypertension remains untreated or poorly controlled over many years.
Regular blood pressure monitoring, medication adherence, and lifestyle changes can help protect both kidney and cardiovascular health.
Older adults
Kidney function often declines to some degree with age, although the extent varies widely between individuals.
Older adults are also more likely to have diabetes, hypertension, cardiovascular disease, and take medications that can affect kidney function.
Age alone does not mean that someone has kidney disease. However, clinicians may consider a person's overall risk profile when deciding whether testing is appropriate.
People with a family history of kidney disease
Some kidney conditions have a genetic component.
For example, autosomal dominant polycystic kidney disease can cause fluid-filled cysts to develop in the kidneys and may eventually impair their function.
A family history of kidney failure, inherited kidney disease, or kidney problems at an unusually young age is worth discussing with a healthcare professional.
People with cardiovascular disease
The heart and kidneys work closely together to regulate circulation, blood pressure, and fluid balance.
Heart disease and kidney disease frequently coexist, and each can make the other more difficult to manage.
People with heart failure, coronary artery disease, or other cardiovascular conditions may benefit from appropriate kidney monitoring.
People who use certain medications frequently
Some medications can injure the kidneys, especially when used at high doses, for prolonged periods, or during dehydration.
Nonsteroidal anti-inflammatory drugs, commonly known as NSAIDs, include ibuprofen and naproxen. These medications can reduce blood flow to the kidneys in susceptible individuals.
The risk may be higher in people with chronic kidney disease, dehydration, heart failure, or those taking certain blood pressure medicines and diuretics.
This does not mean everyone must avoid these medicines. It means that people with kidney risk factors should discuss safe use, dosage, and alternatives with a healthcare professional.
Never stop prescribed medication without consulting the clinician who manages your treatment.
How Doctors Test for Kidney Disease
Symptoms alone are not sufficient to confirm or exclude kidney disease. Fortunately, several relatively simple tests can provide important information.
1. Blood creatinine and estimated glomerular filtration rate
Creatinine is a waste product generated by normal muscle metabolism. Healthy kidneys remove it from the blood.
A blood test measures creatinine, and clinicians use this result along with factors such as age and sex to estimate the glomerular filtration rate, commonly called eGFR.
The eGFR provides an estimate of how effectively the kidneys filter blood.
In general, a lower eGFR indicates reduced filtration, but results must be interpreted in context. Creatinine levels can be influenced by muscle mass, diet, certain medications, and other factors.
An eGFR below 60 mL/min/1.73 mยฒ that persists for at least three months is one criterion for chronic kidney disease. A single low result does not automatically establish chronic disease, because acute illness or temporary kidney injury can also reduce kidney function.
Likewise, an eGFR of 60 or higher does not rule out kidney disease if other abnormalities, such as persistent albuminuria, are present.
2. Urine albumin-to-creatinine ratio
A urine albumin-to-creatinine ratio, or UACR, measures albumin in the urine relative to creatinine.
Albumin is a protein that normally remains largely within the bloodstream. Elevated urinary albumin can indicate damage to the kidney's filtering structures.
A UACR of 30 mg/g or higher is generally considered abnormal and may require confirmation and further evaluation.
Because urinary albumin can temporarily rise after strenuous exercise, during an infection, or under other circumstances, clinicians may repeat testing before making a diagnosis.
This test is especially useful because albuminuria can identify kidney damage even when the eGFR remains relatively normal.
3. Urinalysis
A urinalysis can detect blood, protein, and other abnormalities in the urine.
Depending on the findings, a clinician may recommend additional tests to investigate infection, inflammation, or other conditions.
Urinalysis is useful, but a standard dipstick test may not detect every clinically important degree of albuminuria. A UACR is often preferred when specifically assessing albumin leakage.
4. Blood pressure measurement
Blood pressure testing helps identify a major risk factor for kidney damage.
It also helps clinicians determine whether existing kidney disease may be contributing to hypertension.
The appropriate blood pressure target depends on a person's overall health, kidney condition, cardiovascular risk, and treatment tolerance.
5. Imaging and additional tests
In selected cases, a clinician may recommend kidney ultrasound or other imaging to investigate structural abnormalities, cysts, kidney stones, or urinary obstruction.
Additional blood tests, urine studies, or specialist assessments may be appropriate depending on the suspected cause.
Not everyone needs every test. The evaluation should be tailored to the person's symptoms, medical history, risk factors, and initial results.
Can Kidney Disease Be Prevented?
Not every case of kidney disease can be prevented, particularly when inherited conditions or certain immune-related diseases are involved. Nevertheless, several habits can reduce risk and help preserve kidney function.
Keep blood pressure under control
Blood pressure management is one of the most important ways to protect the kidneys.
Follow the treatment plan recommended by your healthcare professional, monitor readings as advised, and attend follow-up appointments.
Do not discontinue blood pressure medication simply because you feel well. Hypertension often causes no symptoms even when it is damaging blood vessels.
Manage blood glucose if you have diabetes
Consistently elevated blood glucose can damage the kidneys over time.
A suitable diabetes management plan may include nutrition changes, physical activity, medication, and regular monitoring.
Some medicines used to treat diabetes also provide kidney and cardiovascular benefits in appropriate patients. A clinician can determine whether these treatments are suitable based on kidney function and other medical factors.
Eat a balanced diet
A kidney-supportive eating pattern generally emphasizes vegetables, fruits, whole grains, suitable protein sources, and less highly processed food.
Reducing excessive sodium intake can help control blood pressure and fluid retention.
For many adults, a commonly recommended sodium limit is around 2,300 milligrams per day, although individual requirements and clinical recommendations vary.
Large amounts of sodium may come from packaged snacks, processed meats, instant noodles, sauces, canned foods, and restaurant meals.
People with established kidney disease may need individualized advice about potassium, phosphorus, protein, and fluid intake. These requirements vary by disease stage, laboratory results, medications, and other conditions.
Do not automatically eliminate bananas, tomatoes, dairy products, or other nutritious foods simply because you are concerned about kidney health. Restrictions should be based on actual medical needs.