Tests to Detect Diabetes-Linked Kidney Disease
In the fight against diabetes-related complications, early detection and management play a crucial role, particularly in the case of diabetic kidney disease (DKD). This condition, also known as diabetic nephropathy, is a common complication of both Type 1 (T1D) and Type 2 (T2D) diabetes.
The recommended screening tests for DKD are urine albumin measurement (albuminuria test) and estimated glomerular filtration rate (eGFR) via serum creatinine. These tests are essential for early detection and management of DKD because they identify kidney damage and declining kidney function before symptoms appear.
Urine Albumin-to-Creatinine Ratio (UACR) is a urine test that detects albumin leakage into urine, an early sign of kidney damage from diabetes. A UACR greater than 30 mg/g suggests DKD, even before eGFR declines. Regular monitoring helps track disease progression and treatment effectiveness.
The eGFR, calculated from serum creatinine, estimates how well the kidneys filter blood. An eGFR below 60 mL/min/1.73 m² indicates chronic kidney disease. eGFR helps stage kidney disease and guide clinical decisions.
In addition to these tests, doctors may also assess blood pressure, glycated hemoglobin (HbA1c) or blood glucose levels, and Body Mass Index (BMI) to monitor diabetes control and kidney disease risk.
Early detection can prevent complications like kidney failure and cardiovascular disease. Regular screening in at-risk individuals, such as people with diabetes, hypertension, obesity, or other comorbidities, supports personalized treatment and monitoring strategies.
A kidney biopsy may be used when the doctor suspects a rapid progression in renal function impairment and severe proteinuria. This minimally invasive procedure can reveal protein deposits, unusual scarring, and inflammation not easily identified by other screening tests.
Imaging tests, such as renal ultrasound, CT scan, X-ray, or MRI scan, help doctors visualize the kidney to look for any problems or damage.
Health experts recommend people living with diabetes receive annual renal screenings to check for kidney problems. Individuals with comorbidities or risk factors may require more frequent screenings.
The American Diabetes Association (ADA) recommends annual renal screening for people with diabetes, with screenings 5 years after diagnosis for people with T1D and screening at diagnosis for those with T2D.
In summary, urine albumin testing and serum creatinine-based eGFR are central screening tests for DKD, enabling early detection, risk stratification, and management to improve kidney outcomes in diabetes. Regular screening and careful monitoring are essential for those with diabetes to ensure timely interventions and optimal health.
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