Diabetes-related nephropathy is a potential complication of diabetes. Tests to help screen for nephropathy include urine protein tests, imaging tests, kidney biopsy, and glomerular filtration rate.

Diabetes-related nephropathy or diabetic kidney disease is a common complication of diabetes, including diabetes type 1 (T1D) and diabetes type 2 (T2D).

A 2022 article estimates that the condition affects 30–40% of people with diabetes. According to health experts, the condition usually occurs following damage to the blood vessels in the kidneys, which prevents them from functioning as they should.

A doctor will recommend several screening tests because there is currently no cure for diabetes-related nephropathy. These tests can help detect the onset of the condition, which can assist in managing the condition.

In this article, we will discuss the screening tests available for diabetes-related nephropathy.

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An early sign of kidney disease is proteinuria, a condition that occurs when protein leaks into the urine. Certain tests can measure the levels of protein in a urine sample. These tests include a dipstick urine test and a urine albumin-to-creatinine ratio (UACR).

A dipstick urine test can detect the albumin level in a sample of urine. While this test allows the doctor to see if the protein levels are atypical, it does not provide an exact measurement.

The UACR test measures the amount of albumin — an essential protein in blood and compares it to creatinine — a waste product from protein digestion. A UACR test result may show the following:

  • 30 milligrams (mg) is within a typical range
  • 31–299 mg may indicate early kidney disease or microalbuminuria
  • 300 mg or above may indicate advanced kidney disease or microalbuminuria

The estimated glomerular filtration rate measures how well the nephrons in the kidneys filter blood. Medical experts believe it is the best index for kidney function. Doctors calculate eGFR using a person’s serum creatinine and cystatin C level in combination with demographic factors such as age, race, and gender.

The eGFR results may show the following:

  • An eGFR score of 60 or higher indicates typical function.
  • An eGFR score below 60 may indicate kidney disease.
  • An eGFR score under 15 may indicate kidney failure.

The eGFR level can help a healthcare professional to:

  • detect the progression of kidney disease
  • monitor the severity of the condition
  • make an accurate diagnosis
  • map out the right treatment

The American Diabetes Association (ADA) notes that medical experts frequently report low eGFR scores in T1D and T2D due to the increasing prevalence rate of diabetes.

Imaging tests are noninvasive procedures that help doctors visualize internal organs and structures. It enables them to get a picture of the kidney to look for any problems or damage.

The doctor may recommend a renal ultrasound, CT scan, X-ray, or MRI scan to reveal how blood flows through the kidney or if there is any blockage or narrowing in the blood vessels.

According to a 2020 study, noninvasive imaging is a safe and effective procedure in screening diabetes-related nephropathy.

The doctor may recommend a kidney biopsy when they suspect a rapid progression in renal function impairment and severe proteinuria. Also, they may be necessary to help detect potentially severe complications that may arise.

A kidney biopsy is a minimally invasive procedure where the doctor inserts a thin needle through the skin to remove a sample of kidney tissue. The doctor will then examine it under the microscope for any signs of damage or disease.

The kidney biopsy can reveal protein deposits, unusual scarring, and inflammation that other screening tests may not easily identify.

The ADA recommends annual renal screening for people with diabetes. They recommend screenings 5 years after diagnosis for people with T1D and screening at diagnosis for those with T2D.

However, individuals with comorbidities or risk factors may require more frequent screenings. These may include:

A 2021 review indicates that diabetes-related nephropathy usually occurs without symptoms in its early stages, and many people remain without diagnosis and treatment. This is why it is advisable for those with diabetes to have regular annual checks, including tests for kidney health.

As diabetic kidney disease does not typically present with symptoms, screening tests, such as blood and urine tests, are the best way to monitor kidney health and help doctors to diagnose the condition.

According to a 2021 study, screening may offer the following benefits:

  • enables early kidney disease diagnosis
  • access to counseling
  • access to early treatment
  • referral to a nephrologist when appropriate

Diabetes-related nephropathy describes kidney problems that may occur as a complication of diabetes. It occurs due to damage in the blood vessels of the kidneys, preventing them from functioning optimally.

Screening is integral to diagnosing, treating, and managing diabetes-related nephropathy since there is currently no cure for the condition. These tests include urine protein tests, estimated glomerular filtration rate (eGFR), imaging, and kidney biopsy. Health experts recommend people living with diabetes receive annual renal screenings to check for kidney problems.