Diabetic Kidney Disease

Causes & Risk Factors

Diabetic kidney disease develops as a direct consequence of prolonged elevated blood glucose affecting the kidneys:

•  Duration of diabetes — risk increases with longer duration of diabetes, particularly if glucose control has been suboptimal.

•  Poor glucose control over time contributes directly to the kidney damage seen in diabetic kidney disease.

•  Coexisting hypertension significantly accelerates kidney damage in people with diabetes.

•  Genetic factors influence individual susceptibility to developing kidney complications from diabetes.

•  Smoking and obesity are additional contributing risk factors.

Symptoms & When to Test

Diabetic kidney disease, like CKD generally, is often asymptomatic in its earlier stages, which is why routine screening in diabetic patients is emphasized regardless of symptoms.

•  Often asymptomatic in early stages

•  Swelling in the legs or around the eyes, as disease progresses

•  Fatigue, in more advanced disease

•  Foamy or frothy urine, which can be a sign of significant protein loss

When Should You Consider Testing?

Routine annual screening with urine ACR and kidney function testing is generally recommended for all patients with diabetes, regardless of symptoms, given the silent nature of early diabetic kidney disease.

Why Tests Are Combined

Urine ACR and eGFR together provide the core assessment for diabetic kidney disease — urine ACR detects early albumin leakage (often the first detectable sign), while eGFR tracks overall filtration capacity, and monitoring both provides a more complete picture than either alone.

HbA1c is included specifically because it connects glucose control history to kidney risk — since the degree of glucose control over time is a key modifiable factor influencing whether and how quickly diabetic kidney disease develops or progresses.

Urinalysis complements ACR by screening for other urinary abnormalities (blood, glucose) that could indicate additional or alternative causes of urinary findings beyond diabetic kidney disease alone.

Tests Available at NPL

Preparation requirements vary by specific test — please follow the instructions provided by your doctor or NPL for the tests ordered.

Home Sample Collection

NPL offers convenient home sample collection for Diabetic Kidney Disease blood tests, so you don't need to visit a lab in person.

→ Book your test online, via the NPL app, or by calling +977 1 5970147 and select a convenient time slot for home sample collection.

→ A certified and experienced NPL phlebotomist visits your home at the scheduled time, following strict hygiene and safety protocols.

→ Your sample is transported under controlled, monitored conditions to NPL's NABL ACCREDITED UNDER ISO 15189:2012laboratory for processing.

→ Your digital report is delivered securely to your phone or email, along with access to download and share it as needed.

When to See a Doctor

•  Known diabetes — annual kidney screening (urine ACR and eGFR) is recommended regardless of symptoms

•  Swelling in the legs or around the eyes

•  Foamy or frothy urine

•  Diabetes with poor glucose control history — discuss kidney monitoring frequency with your doctor