If you have diabetes, looking after your kidneys is very important. Diabetes is one of the main causes of kidney disease in the UK. This guide explains how your kidneys work, how diabetes can affect them, how we monitor kidney health, and what you can do to protect your kidneys.
What do your kidneys do?
You have two kidneys. They are bean-shaped organs about the size of your fist, found in your lower back.
- Main job: They clean your blood by removing waste and extra fluid, which becomes urine.
- Other jobs: They help control blood pressure, make red blood cells, and keep your bones healthy by balancing minerals like calcium and phosphorus.
Your kidneys are always working to keep you well, even while you sleep.
How can diabetes affect the kidneys?
High blood sugar levels over time can damage the tiny blood vessels in your kidneys. These blood vessels act like filters. If they are damaged, your kidneys can’t clean your blood properly.
- High blood sugar: Makes the filters leak, so protein escapes into your urine.
- High blood pressure: Puts extra strain on your kidneys and speeds up the damage.
This damage is called diabetic kidney disease (also known as diabetic nephropathy).
If the damage gets worse, the kidneys can stop working properly. This is called kidney failure. People with kidney failure may need dialysis or a kidney transplant.
How do we check kidney health?
There are two key tests used by the NHS to check your kidneys if you have diabetes:
- Urine test for protein (Urinary albumin/ACR test)
- What it does: Looks for a protein called albumin in your urine.
- Why it matters: Healthy kidneys should not let albumin leak into urine. If they do, it could be an early sign of kidney damage.
- Where it’s done: You provide a urine sample at your GP surgery or clinic.
- How often: Once a year (or more often if needed).
- Blood test for kidney function (Creatinine and eGFR)
- What it does: Measures the level of creatinine (a waste product) in your blood.
- eGFR (estimated Glomerular Filtration Rate): This shows how well your kidneys are filtering your blood.
- Why it matters: A lower eGFR means your kidneys are not working as well as they should.
- Where it’s done: A nurse or phlebotomist takes your blood at your GP surgery or a local clinic.
- How often: Once a year (or more often if needed).
How can you protect your kidney health?
There are many things you can do to keep your kidneys healthy if you have diabetes:
- Keep your blood sugar in target range
- Use your HbA1c test results to see how well your blood sugar is managed.
- Follow your diabetes care plan, take medication as prescribed, and talk to your healthcare team if your levels are too high.
- Common diabetes medications include metformin, gliclazide, insulin, or newer options like dapagliflozin (which can also help protect the kidneys).
- Control your blood pressure
- Aim for a blood pressure under 140/90 (or lower if advised).
- Reducing salt in your diet, exercising, and taking blood pressure tablets can help.
- Commonly prescribed medications include ramipril, lisinopril, or losartan. These belong to a group of medicines called ACE inhibitors or ARBs which help lower blood pressure and protect your kidneys.
You can read our article here on tips for taking your medications safely and effectively.
- Don’t smoke
- Smoking damages your blood vessels, including those in your kidneys.
- Ask your GP, nurse, or pharmacist for help to quit.
- NHS-approved stop smoking medications may include nicotine patches, varenicline (Champix), or bupropion (Zyban).
- Eat a healthy diet
- Eat more fruit, vegetables, whole grains, and lean protein.
- Cut down on processed foods, salt, and saturated fat.
- Stay active
- Aim for 30 minutes of activity most days, such as walking, swimming, or dancing.
Read our article here for more ideas on how to move your body more throughout the day.
- Drink plenty of water
- Staying hydrated supports kidney function.
If you’d like to explore more about how to stay hydrated, read up on our top hydration tips here.
- Take your medicines as prescribed
- Some people with diabetes are given ACE inhibitors (Angiotensin-Converting Enzyme Inhibitors) or ARBs (Angiotensin Receptor Blockers) even if their blood pressure is normal. These help protect the kidneys.
- Examples include: ramipril, enalapril, lisinopril, or losartan.
You can read our article here on tips for taking your medications safely and effectively.
What if there is a problem?
If your tests show early signs of kidney damage:
- Your healthcare team will talk to you about your results.
- You may need more regular tests.
- They might change your medication or suggest lifestyle changes.
Finding problems early means treatment can slow or stop the damage.
Support from the NHS
- All kidney tests are available for free on the NHS as part of your diabetes care.
- Your GP practice will usually invite you for these tests each year.
- Ask about your results and what they mean.
Take control of your kidney health with these tips
- Diabetes can damage your kidneys, but regular tests and healthy habits can protect them.
- Look after your blood sugar, blood pressure, and general health.
- Have your urine and blood tests every year.
- Talk to your healthcare team if you have questions or need support.
You are the most important person in your diabetes care. Looking after your kidneys now will help you stay healthy for years to come.
Track your kidney health with the Evergreen Life app
Monitoring your health is one of the most powerful steps you can take in managing diabetes – and the Evergreen Life app is here to support you.
If you link to your GP record, you may be able to view your blood and urine test results from your GP. You can self-enter your own blood pressure readings, and stay on top of your healthcare appointments, all in one place. You can also explore questionnaires on wellness topics like nutrition, fitness and hydration to support you with your overall health.
With the right tools, you can feel more in control of your kidney health every day.
✅ If you haven’t already, download the free Evergreen Life app to keep an eye on your results and feel more confident in your diabetes journey.
- NHS – Chronic Kidney Disease (CKD) Overview
https://www.nhs.uk/conditions/kidney-disease/
Offers a detailed explanation of kidney disease, symptoms, causes (including diabetes), diagnosis, treatment, and lifestyle advice. - Diabetes UK – Kidneys and Diabetes
https://www.diabetes.org.uk/guide-to-diabetes/complications/kidneys-nephropathy
Focuses on how diabetes affects kidney function, signs of kidney problems, and ways to reduce your risk. - NICE – Chronic Kidney Disease: Assessment and Management (NG203)
https://www.nice.org.uk/guidance/ng203
Provides recommendations for assessing and treating kidney disease, especially in people with diabetes. - NHS – Diabetes and Kidney Tests (ACR and eGFR)
https://www.nhs.uk/conditions/diabetes/diabetes-complications/kidney-disease/
Covers how and why the NHS uses urine and blood tests to monitor kidney function in people with diabetes. - Diabetes UK – Kidney Disease Information Prescription
https://www.diabetes.org.uk/resources-s3/2023-07/kidney-disease.pdf
A downloadable leaflet that explains kidney health, how to protect it, what tests are needed, and what results mean.
