2 tests you don’t want to miss if you have diabetes

Do you have diabetes? Then you know that managing your blood sugar is key to staying healthy. Diabetes is a complex medical problem. And it can affect many parts of your body, including your kidneys. In fact, almost 1 in 3 adults with diabetes also have chronic kidney disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 

Chronic kidney disease means your kidneys are damaged and can’t filter your blood the way they’re supposed to. Most cases of chronic kidney disease are caused by diabetes. That’s because the blood vessels in kidneys can be damaged if blood sugar is too high for too long.  

People with diabetes should have their kidney health checked annually. This can be done with two simple tests. Early kidney disease usually doesn’t have symptoms, but these tests can help your provider catch signs early. 

Here’s what you need to know. 

Albumin-to-creatinine ratio test 

Known as an ACR, this test is done through a urine sample. It looks at two key compounds in your urine: a protein called albumin, and a waste product called creatinine. 

Albumin is made by your liver. It is an important protein that works to keep the right amount of fluid in your bloodstream. It is not normally in urine. If your kidneys are healthy, they keep albumin in your bloodstream. But if your kidneys are damaged, they start to allow albumin and other proteins into your urine.  

Creatinine is a waste byproduct of muscle repair. It needs to be shuttled out of the body. Your kidneys act as the garbage collector. They put the creatinine from your blood into your urine at a steady rate so it can get passed out of your body.  

An ACR compares both compounds to see if albumin is being excreted in urine at a higher rate than normal.  

A normal albumin-to-creatinine ratio is less than 30 mg/g. A consistent ratio of 30 mg/g means you could be at higher risk of kidney damage, according to the National Kidney Foundation. Smaller amounts of albumin could suggest early stage kidney disease. Higher amounts of albumin could point to more severe kidney disease. 

Glomerular filtration rate test 

Called a GFR for short, this blood test is another measure of how well your kidneys are working. It looks at tiny filters in the kidneys called glomeruli to see how much blood is moving through them per minute.  

That gives your provider an idea of how well your kidneys are filtering out creatinine and extra fluid. A GFR also looks at your age, gender, race, and weight.  

Here’s how to read your GFR results: 

• 60 or more: GFR is normal. 
• Below 60: You might have kidney disease and should see a specialist called a nephrologist. 
• 15 or less: This is a sign of kidney failure. At this stage, you would need dialysis or a kidney transplant.   

Why do I need these kidney tests every year? 

The NIDDK says that anyone with diabetes should get these tests at least once a year. Here’s why you shouldn’t skip them: 

Many people don’t have symptoms of kidney problems in the early stages. Getting your kidneys checked with a blood or urine test is the only way to find out for sure if you have developed chronic kidney disease. Early testing can mean early detection and early treatment to stop more kidney damage from happening. 

Testing can show if your treatment is working. What if you’ve already been diagnosed with chronic kidney disease and you’re being treated? These tests can let you know if your kidney damage has slowed down or stopped. That shows that your treatment is on track. Treatment deals with the conditions (such as diabetes) that caused kidney damage, so it doesn’t get worse.  

Testing can help prevent kidney failure later. If left untreated, kidney disease can cause kidneys to stop functioning completely. The only way to know if the disease is progressing is to get tested as directed by the doctor. That way, your provider will know when it’s time to adjust medications or other care if needed.  

Article sources: 

Chronic kidney disease basics: National Institute of Diabetes and Digestive and Kidney Diseases  
ACR test: National Library of Medicine: MedlinePlus; National Kidney Foundation 
GFR test: National Kidney Foundation 
Testing recommendations: National Institute of Diabetes and Digestive and Kidney Diseases