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Diabetes is a chronic health condition where blood sugar is too high. People with diabetes either don’t make insulin, the hormone that regulates blood sugar, or don’t use insulin well. Diabetes is also associated with a variety of other health problems.

People with diabetes are at an increased risk of developing kidney disease. In fact, according to the National Institute of Diabetes and Digestive and Kidney Disease, 1 in 3 adults with diabetes has kidney disease.

Glomerular filtration rate is a test that’s important in the diagnosis and monitoring of kidney disease. Keep reading to learn more about this test, what the results mean, and how it plays a role in diabetic kidney disease.

Your kidneys work to filter waste products and excess fluids from your blood, which are then released from your body as urine.

A glomerular filtration rate (GFR) test measures how well your kidneys are carrying out their filtration function.

Because early kidney disease often has no symptoms, a GFR test is a valuable tool for monitoring kidney function. This is particularly important if you’re at an increased risk of kidney disease, especially if you have diabetes.

Estimated glomerular filtration rate

Because testing GFR can be very complex, it’s often estimated. You may see this called an estimated glomerular filtration rate (eGFR) test.

eGFR uses the results from a blood test for creatinine, a waste product produced by your muscles. While creatinine production can vary by individual, high levels in the blood can potentially indicate decreased kidney function.

Once the result of the creatinine test is obtained, it’s plugged into a formula that also includes variables like age and sex. The result of the formula is your eGFR, an estimate of your kidney function.

A GFR of 60 or higher is considered within the normal range. A GFR lower than 60 may be an indication that you have kidney disease.

When GFR falls to 15 or lower, it can be a sign that you have kidney failure.

GFR measurements can vary by age. As you get older, GFR naturally decreases. For most adults, a GFR of over 90 is considered normal.

If your GFR is below 60, it may be a sign of kidney disease, which means that your kidney function may be impaired.

While there typically aren’t symptoms in the early stages of kidney disease, the symptoms of kidney disease in the later stages can include:

A GFR of 15 or lower is a sign of kidney failure. This is when your kidneys stop being able to effectively filter wastes and extra fluids from your blood. People with kidney failure need dialysis or a kidney transplant to survive.

It’s also possible for GFR to be very high in some people. This is called glomerular hyperfiltration. In some individuals with glomerular hyperfiltration, GFR can go as high as 180.

Glomerular hyperfiltration can happen in the early stages of diabetes. Although additional research is needed to fully understand the significance of glomerular hyperfiltration, it’s believed to be associated with an increased risk of kidney damage.

Diabetic kidney disease can happen in both type1 and type 2 diabetes. However, it’s more common in type 2 diabetes. About half of people with type 2 diabetes develop diabetic kidney disease, compared to about one-third of people with type 1 diabetes.

Your kidneys filter wastes and extra fluids from your body using tiny blood vessels called capillaries. High levels of sugar in your blood — which happens with diabetes — can damage blood vessels in your body, including the tiny blood vessels in your kidneys.

When blood vessels in the kidneys are damaged, they don’t filter wastes and extra fluids effectively. A blood protein called albumin may be detectable in the urine at this point. Along with low GFR, albumin in the urine can be a sign of kidney disease.

Additionally, many people with diabetes also develop high blood pressure. By itself, high blood pressure is also a risk factor for kidney disease, as it can also damage the kidneys.

In addition to high blood pressure, other factors that may increase your risk of diabetic kidney disease if you have diabetes include:

  • not following your diabetes treatment plan
  • being an older age
  • having had diabetes for a long time
  • smoking cigarettes
  • being overweight or having obesity
  • engaging in low levels of physical activity
  • having heart disease
  • having a family history of kidney disease

Although it’s still unclear exactly why, certain races and ethnic groups are also at an increased risk of kidney disease. This includes individuals who are:

  • Black
  • Hispanic
  • Asian
  • American Indian or Pacific Islander

One reason for this increased risk may be inequities in healthcare.

If you have diabetes, there are several steps that you can take to help lower your risk of diabetic kidney disease. Let’s look at each of these factors.

  • Stick to your treatment plan. To reduce the risk of diabetes complications like diabetic kidney disease, it’s vitally important to follow the diabetes treatment plan developed by your doctor. This includes:
    • seeing your doctor every 3 to 6 months to have your A1C tested
    • making an appointment with your doctor if you have consistently high blood sugar readings
  • Treat high blood pressure. Because high blood pressure increases the risk of kidney disease, it’s important to monitor your blood pressure. If you have high blood pressure, your doctor can prescribe medications to help manage it.
  • Address high cholesterol. Having high cholesterol can contribute to heart disease and cause further damage to blood vessels. If you have high cholesterol, it can be managed using medications called statins.
  • Quit smoking. Smoking also increases your risk of kidney disease. If you smoke, consider speaking to your doctor about developing a plan to quit.
  • Manage weight. If you are overweight or have obesity, ask your doctor about healthy ways to lose weight.
  • Get regular exercise. Regular exercise is good for both your physical and mental health. It can also help lower blood pressure and aid in weight management.
  • Drink alcohol in moderation or not at all. Drinking too much alcohol can be hard on both your liver and your kidneys. It may also increase your blood pressure. If you drink alcohol, be sure to do so in moderation.
  • Avoid certain medications. Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can lead to kidney damage. Ask your doctor about the medications to avoid and which ones are safe for you to take.
Screening for kidney disease

If you have diabetes, your doctor will screen you for kidney disease each year by measuring GFR and urine albumin levels. This yearly screening can help detect kidney disease early and prevent additional damage from occurring.

If you have diabetes and kidney disease, it’s important to know that you aren’t alone. There are many places you can reach out to for resources and support, such as:

You can also find diabetes resources within the Healthline community. This includes:

Additionally, you can find more information about kidney disease by checking out the websites for the National Kidney Foundation or the American Kidney Fund.

People with diabetes are at an increased risk of developing kidney disease. This is because high blood sugar levels can damage the blood vessels in your kidneys. This can affect how well your kidneys are able to filter your blood.

One of the ways that kidney function is measured is with a GFR test. Having a lower-than-normal GFR can indicate kidney disease or even kidney failure.

If you have diabetes, your doctor will check your kidney function yearly by testing and measuring your GFR and urine albumin levels. To lower your risk of kidney disease, it’s important to stick to your treatment plan and to manage your blood pressure.