Diabetes: How does it affect the kidneys? Dr. Kim Pugh: When the kidney disease is what we call small vessel disease and again it boils down to vascular complications that having ample sugars. And the disease is known as nephropathy, diabetic nephropathy. The main thing I can tell folks is they need to make sure that their physician does a test called urine microalbumin and that test for small amounts of albumin, which is precursor to kidney disease. If you catch that early and you control the blood pressure and control the blood sugars, you have a good chance of avoiding the long-term complications. You hate the threatened patients but you know, what's good, either to control your blood sugar, your blood sugar, or ultimately look at being on dialysis.