Diabetes and Kidney Disease
Diabetes is the single biggest cause of kidney disease in India, and the damage builds silently for years before creatinine ever moves. Good control on the diabetes side protects the kidneys directly.
Medically reviewed by the RIIMS medical team · Last updated: June 2026
Go to hospital now
- Very little or no urine output
- Breathlessness at rest or when lying flat
- Confusion together with a very high or very low blood sugar reading
See a doctor soon (not an emergency)
- New or worsening swelling in the feet or around the eyes
- Protein or foam newly noticed in the urine
- Blood pressure that has stopped responding to your usual medicine
How does diabetes affect the kidneys?
Diabetes damages the kidneys' filtering units gradually over years of high blood sugar, and it is the leading cause of kidney disease in India today. High blood pressure often travels alongside diabetes and adds its own strain on the same filters, so the two are usually managed together rather than as separate problems. For the detailed picture of how each type of damage progresses, see our pages on diabetic kidney disease and hypertensive kidney disease. The earliest sign in diabetes is not a rising creatinine but a small amount of protein leaking into the urine, called microalbuminuria, which a urine ACR test can pick up years before creatinine or eGFR move outside their normal range. This page focuses on what day-to-day diabetes control means for kidney protection: annual screening, a lower blood pressure target once the kidneys are involved, agreed with your treating doctor, and coordinating sugar and blood pressure treatment as one plan rather than two separate ones.
Symptoms to watch for
- Usually no symptoms for years, screening is what catches it
- Protein or foam in the urine (microalbuminuria)
- Gradually rising creatinine or falling eGFR
- Blood pressure becoming harder to control
- Swelling in the feet as damage advances
- Frequent urination at night
When to consult a doctor
Everyone with diabetes should have a urine ACR and eGFR test at least once a year, even without symptoms. If protein appears in the urine, blood pressure becomes hard to control, or creatinine starts rising, ask for a kidney-focused review without delay.