Kidney function monitoring chronic disease

Overview

Kidney function monitoring means regular check-ups to see how well your kidneys are working. This is especially important if you have a long-term health condition like diabetes or high blood pressure, because these can damage your kidneys over time. The tests help catch any problems early so you and your doctor can take steps to protect your kidneys.

Yes, many people with long-term conditions such as diabetes or high blood pressure need regular kidney function monitoring.

It mainly affects people who have diabetes, high blood pressure, a family history of kidney disease, or who are older. It can also affect people with heart disease, obesity, or a history of kidney infections.

Symptoms

Common symptoms

• Feeling more tired than usual
• Swelling in your feet, ankles, or hands (oedema)
• Changes in how much you urinate or how often you go
• Foamy or bubbly urine

Symptoms in children

• Not growing as expected for their age
• Frequent bedwetting after they were previously dry
• Swelling around the eyes or face in the morning

Symptoms in older adults

• Confusion or trouble concentrating
• Loss of appetite or weight loss
• Muscle cramps at night

Causes

Main causes

• Diabetes: high blood sugar can damage kidney filters over time
• High blood pressure: can strain the small blood vessels in the kidneys
• Glomerulonephritis: inflammation of the kidney’s filtering units
• Repeated kidney infections

Risk factors

• Having diabetes or high blood pressure
• Being over 60 years old
• A family history of kidney disease
• Obesity
• Smoking

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency or urgent symptoms listed above

Book a routine appointment if:

• Once a year for a blood test and urine test if you have diabetes or high blood pressure
• More often if your doctor says your kidney function is changing

Diagnosis

Kidney function is checked with simple blood and urine tests that tell your doctor how well your kidneys are filtering waste. Your doctor may also order an ultrasound to look at your kidney size and structure.

Tests that may be done

• Blood test: measures creatinine and calculates eGFR (estimated glomerular filtration rate) — a number that shows how well your kidneys filter blood
• Urine test: checks for protein or albumin (a type of protein) in your urine, which can be a sign of damage
• Ultrasound: uses sound waves to create a picture of your kidneys

What to expect at your appointment

You do not need to do anything special for these tests. For the blood test, a small amount of blood is taken from your arm. For the urine test, you will provide a sample in a cup. The ultrasound is painless — a gel is put on your back and a small device is moved over the skin. Results usually come back within a few days.

Treatment

The main goal of treatment is to protect your kidneys from further damage. This is done by managing the underlying condition that is hurting your kidneys — usually diabetes or high blood pressure — and by making healthy lifestyle changes.

Self-care at home

• Keep your blood pressure and blood sugar in healthy ranges using lifestyle changes and any medicines prescribed by your doctor
• Stay at a healthy weight
• Drink enough water, but not too much — ask your doctor what is right for you
• Avoid taking too many over-the-counter pain relievers called NSAIDs (such as ibuprofen or naproxen), as they can harm kidneys

Medical treatments

Your doctor may prescribe medicines to lower blood pressure and protect your kidneys. These belong to groups called ACE inhibitors or ARBs. They may also prescribe a type of medicine called SGLT2 inhibitors for people with diabetes to protect the kidneys. Always take medicines exactly as your doctor tells you. If your kidney function gets worse over time, you may need treatments such as dialysis (a machine that filters your blood) or a kidney transplant.

When is surgery considered?

Surgery is not part of routine monitoring. A kidney transplant may be considered if kidney failure develops.

Living with this condition

You can live fully with chronic kidney disease by staying on top of your check-ups, taking your medicines, and being aware of changes in your body. Keep a record of your test results and talk to your doctor if numbers change.

Lifestyle tips

• Exercise moderately for 30 minutes most days (walking, swimming, cycling)
• Do not smoke — smoking harms kidneys even more
• Limit alcohol to no more than 14 units per week

Diet and exercise

A kidney-friendly diet usually includes less salt, less processed food, and moderate protein. You do not need to restrict everything, but ask your doctor or a dietitian for guidance. Staying active helps control blood pressure and blood sugar, which protect your kidneys.

Mental health and emotional wellbeing

Living with a chronic condition can be worrying. You may feel anxious about the future or frustrated with lifestyle changes. It is normal. Talk to your doctor or a counsellor if these feelings last. You are not alone.

Prevention

You can lower your risk of chronic kidney disease by managing your blood pressure and blood sugar, staying active, eating a healthy diet, not smoking, and having regular check-ups if you have risk factors.

Vaccines

People with chronic kidney disease should get a yearly flu vaccine and talk to their doctor about the pneumonia vaccine and hepatitis B vaccine.

Screening programmes

If you have diabetes, high blood pressure, or a family history of kidney disease, ask your doctor for a kidney function test at least once a year. This simple screening can catch problems early.

Complications

If left untreated

• Worsening kidney function that may lead to kidney failure (end-stage renal disease)
• Heart disease and stroke
• Anaemia (low red blood cells, causing tiredness)
• Brittle bones and higher risk of fractures

Long-term outlook

With early detection and good management, many people with chronic kidney disease live long, healthy lives. Even if kidney function declines, treatments like dialysis and transplant have helped millions of people continue living active lives. Your outlook depends on your overall health and how closely you work with your healthcare team.

Find support

Local organisations

• National Kidney Foundation · USA
• Kidney Care UK · UK

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