Your kidneys are small but powerful organs. They act like filters and perform critical tasks such as filtering waste products, removing excess fluids, and maintaining a healthy balance of electrolytes in your body². Chronic kidney disease (CKD) is a long-term condition where your kidneys gradually lose their ability to perform these essential tasks. If left unchecked, CKD can progress through several stages, eventually leading to advanced chronic kidney disease or irreversible damage, which may require dialysis or a kidney transplant to manage³.

So, what is CKD, and what are the early signs? CKD is often referred to as a “silent disease,” as it may not cause noticeable symptoms until severe damage has occurred⁴. It develops over time due to damage to the tiny filtering units in the kidneys called nephrons. One of the leading causes of CKD is diabetes, a condition characterized by high blood glucose levels that can cause nerve damage.

Research shows that nearly one in three adults with diabetes also develop CKD, making it the single most common cause of kidney disease globally. You might also be at a higher risk of developing CKD if you have a family history of certain genetic conditions like polycystic kidney disease or autoimmune diseases like lupus or IgA nephropathy¹.

Although several factors like hypertension, genetics, heart disease, and other autoimmune conditions can contribute to CKD—diabetes stands out as the leading risk factor globally. This is because elevated blood sugar levels over a prolonged period damage the small blood vessels in the kidneys, leading to a reduction in their ability to filter blood effectively⁵. When the filtering units are damaged, they begin to leak protein into the urine. This condition is called diabetic kidney disease or diabetic nephropathy, and it affects approximately 30 to 40 percent of people living with diabetes. If the damage persists over time, the kidneys may stop working altogether, causing harmful waste products to build up in the body⁶. 

Diabetes and high blood pressure are the most common causes of CKD in adults. Poorly managed diabetes can lead to hypertension, and together they contribute to hypertensive chronic kidney disease, which may require treatments such as peritoneal dialysis in advanced stages. Both type 1 and type 2 diabetes can cause these complications if blood glucose and blood pressure levels remain poorly managed⁷.

Lifestyle factors such as obesity and smoking can further amplify these risks, highlighting the importance of a holistic strategy to mitigate complications⁷.
Consult your doctor (kidney specialist) to know more.

You may not feel any different, but your doctor can detect early signs with blood and urine tests. One common early sign is protein in urine, which signals that the kidneys are leaking important proteins that should remain in the blood⁶. Once you begin having symptoms in the later stages, the first sign something is wrong may involve swelling or puffiness in your hands and feet, itchy skin or needing to urinate frequently⁸. Since symptoms vary, it’s best to discuss your concerns with your doctor if you believe there’s something wrong.

If you’ve been newly diagnosed with CKD or are at risk due to diabetes, consulting a nephrologist is crucial. Nephrologists evaluate which CKD stage you are in and develop personalized treatment plans to slow disease progression.
Their recommendations often emphasize patient education, enhancing blood sugar control, managing blood pressure, and making dietary changes to reduce kidney strain. With their expertise, you can better understand the stages of CKD and engage in proactive measures to protect your kidneys.

It's important to be aware of the early signs and how CKD progresses through the different stages to take important steps towards preventing kidney diseases and protecting your kidney health. Remember, early action and guidance from your doctor can make all the difference. Start the conversation today about how to reduce your risks and make lifestyle changes to maintain healthy kidneys.

One of the challenges of CKD is the absence of symptoms in its early stages. This lack of obvious warning signs is why regular tests, including measurements of glomerular filtration rate (GFR) and levels of red blood cells, and protein levels in urine are critical for detecting early CKD in people with diabetes.

If symptoms do appear, it might include blood in your urine, shortness of breath, trouble sleeping, feeling tired or nauseous without any apparent cause. It’s important to be aware of the signs of kidney failure in type 2 diabetes and attend regular health check-ups to detect it as early as possible. You might also notice swelling in your feet or ankles, the need to use the bathroom more often (especially at night) and higher blood pressure readings than normal⁸.

Our body is made up of various interconnected systems, which explains why type 2 diabetes increases your risk of developing other chronic diseases, such as CKD, cardiovascular disease or obesity⁹. For people with type 2 diabetes, it’s especially important to not only monitor your blood sugar levels, but also the⁹:

• Protection of your kidneys
• Health of your heart and blood vessels
• Management of your body fat and weight

• Swelling (Edema): Puffiness in your hands, feet, legs, or around your eyes is a common sign of your kidneys losing their ability to effectively remove excess fluid. This symptom often becomes more pronounced in moderate to severe stages, such as stage 3 or stage 4 of CKD.
• Fatigue: Persistent exhaustion, even after rest, can occur as uremic toxins build up in the bloodstream. Fatigue becomes more common in advanced stages when kidney function is significantly reduced.
• Changes in Urination: As CKD advances, you may notice you need to urinate more frequently, especially at night (nocturia). Another red flag to look out for is foamy urine, which indicates protein leakage (proteinuria), or even blood-tinged urine. These changes are often indicative of damage to the kidney’s filtering units.
• Shortness of Breath: Fluid build-up in the lungs or anemia (a common complication of hypertensive CKD) can cause shortness of breath. Anemia, often seen in late CKD stages, reduces oxygen delivery throughout the body, leading to breathlessness.
• Nausea and Vomiting: As toxins accumulate in the bloodstream (a condition called uremia), you may feel nauseous or experience episodes of vomiting. This symptom tends to surface in CKD stage 4 and beyond¹⁰.

By catching symptoms early, working with CKD specialists, and managing risk factors you can protect your kidneys and prevent further damage. Detecting CKD early through proper monitoring and recognizing these warning signs can make a significant difference in slowing its progression or preventing kidney disease.

CKD progresses in stages, ranging from mild damage in the initial stages to severe kidney damage in the final stage. Your doctor can evaluate your kidney function based on your GFR levels and determine where in the progression you fall.

Doctors classify CKD using a measurement called estimated glomerular filtration rate, or eGFR. This number tells you how well your kidneys are filtering your blood. Think of it as a percentage of your kidney function. Here’s a quick overview of chronic kidney disease stages¹¹:

• Stage 1: Kidney function is normal or close to normal with an eGFR above 90 (GFR ≥90), but there are early signs of damage such as protein in the urine.
• Stage 2: Mild decline in kidney function with an eGFR between 60 and 89, usually with evidence of ongoing kidney damage.
• Stage 3a: Moderate loss of kidney function with an eGFR between 45 and 59.
• Stage 3b: Moderate to severe loss in kidney function with an eGFR between 30 and 44. This stage is a red flag for advancing disease.
• Stage 4: Severe loss of function with an eGFR between 15 and 29.
• Stage 5: Known as end-stage renal disease with an GFR <15, where the kidneys stop working, sometimes called kidney failure. Since this is an advanced stage patients often require life-saving interventions like dialysis or kidney transplantation.

This classification system is called chronic kidney disease staging. If you're concerned about symptoms or your CKD stage, talk to your doctor to get a tailored treatment plan that will support your kidney health and consider the risk of kidney stones and overall well-being.

A diabetes diagnosis doesn’t make kidney damage inevitable. Prevention and early management are the best defences against CKD. People with diabetes can take many steps to prevent kidney disease progressing to more severe stages of the disease¹².

• Control blood sugar: Knowing how diabetes affects your kidneys gives you a roadmap for protection. It starts with keeping your blood glucose within your target range as it is the most important step you can take to slow the progression of CKD.

• Manage blood pressure: High blood pressure puts extra stress on the kidneys and damages them. Medications like ACE (angiotensin converting enzyme) inhibitor or an ARB (angiotensin receptor blocker) may be prescribed to control your blood pressure.

• Adopt a kidney-friendly lifestyle: Staying active, avoiding smoking, eating a balanced diet low in sodium, and maintaining a healthy weight can support kidney health and potentially reduce the risk of digestive and kidney diseases.

• Get regular screening: Annual blood and urine tests are essential. Your doctor will check your eGFR and urine albumin levels. If CKD is diagnosed, your doctor may monitor more often depending on your chronic kidney disease stage.

• Talk to your doctor: Schedule regular visits with a kidney doctor (nephrologist) to check your blood levels and overall health. Understanding your risks and managing health conditions that cause kidney damage are crucial.

Remember CKD often begins silently. Early detection and management can significantly reduce the risk of developing CKD. Your doctor will begin treatment based on the stage of kidney disease you have and what caused it. With the right treatment, you and your doctor can keep your kidneys working as long as possible.

If you’d like to learn more about type 2 diabetes and chronic kidney disease, visit our animated series linked below for more information. If you want to understand the link between type 2 diabetes and cardiovascular disease, you can visit this page.