Nephrology
Diabetes and the kidneys: protecting function early
· Dr James Tataw Ashu · Medically reviewed
Annual albumin testing and modern protective therapy substantially change the course of diabetic kidney disease.
Diabetes remains the most common cause of kidney failure worldwide, yet the early stage of diabetic kidney disease is both detectable and treatable.
The earliest reliable sign is albumin in the urine. An annual albumin-to-creatinine ratio in everyone with diabetes is one of the highest-value tests in medicine.
Treatment combines glycaemic control, blood pressure control, blockade of the renin-angiotensin system and, in appropriate patients, agents that directly protect the kidney and heart.
Avoidable harm is common: repeated courses of nephrotoxic anti-inflammatories, contrast studies without hydration, and dehydration during illness all accelerate decline.
Patients should know their own numbers — filtration rate and albumin ratio — and how they have changed over time. Ownership of those two figures improves engagement more than any leaflet.
This article is general education. It does not constitute individual medical advice and does not create a doctor–patient relationship. For emergencies, contact the emergency services in your current location.
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