How often should a person with diabetes get their kidneys checked?

 For a person living with diabetes, clinical guidelines from the American Diabetes Association (ADA) and KDIGO recommend getting a kidney check at least once a year.

Because diabetes is the leading cause of kidney failure, routine monitoring acts as an essential safety net to catch structural changes years before physical symptoms develop.

However, the exact timeline depends on the type of diabetes you have and your current health status:

The Testing Timeline

• Type 2 Diabetes: You should get your first kidney screening immediately at the time of your diagnosis, and then at least once every year after that. This is because Type 2 diabetes can develop silently years before it is formally detected.

• Type 1 Diabetes: Screening should begin 5 years after your initial diagnosis, and then continue at least once every year moving forward.

When More Frequent Testing Is Needed

"Once a year" is the minimum standard for baseline prevention. Your doctor will likely increase your check-ups to 2 to 4 times a year if your baseline numbers show early signs of kidney involvement:

• Elevated Urine Protein: If your uACR (urine albumin-to-creatinine ratio) test comes back above the normal limit of 30 mg/g, it shows that your kidney filters are experiencing active stress.

• Declining Filtration Rate: If your blood eGFR score drops below 60, it confirms active kidney disease, requiring closer monitoring to track the stability of your filtration system.

• Uncontrolled Blood Pressure: If you are managing both diabetes and high blood pressure, your kidneys face double the workload, and your care team may run tests more frequently to evaluate the efficacy of protective medications (like ACE inhibitors or ARBs).

What the Screening Involves

Every annual check-up should strictly include both of these tests together, as a blood test alone can miss the earliest signs of structural wear:

1. A Simple Blood Test (eGFR): Measures blood creatinine to calculate your active filtering speed.

2. A Quick Urine Sample (uACR): Checks for microalbuminuria (microscopic protein leaks).

Keeping your blood sugar stable (monitored via your HbA1c test) and maintaining your resting blood pressure below 130/80 mmHg are the two single most effective methods to preserve your annual kidney screening scores.