Protein in the urine
The earliest sign of diabetic kidney disease is a small amount of a protein called albumin, which is found in the blood, passing into the urine, i.e. minor albuminuria. The earlier term for it was microalbuminuria. The amount of albumin passed into the urine is so low that it can only be detected using a very sensitive method. Minor albuminuria does not have any symptoms. Often, the blood pressure of a person with type 1 diabetes begins to rise around the same time when albuminuria occurs. In type 2 diabetes, an increase in blood pressure is very common even before kidney changes occur.
Nevertheless, it is very important to spot even a very mild case of albuminuria, because it is a sign of the kidneys having to work overtime and, with proper treatment, it is possible to fix it entirely. That’s why there is a separate annual urine test to screen for urinary albumin excretion.
Kidney failure
In some people with diabetes, the kidney disease progresses. More albumin is passed into the urine. Swelling may occur, if there is a high level of albumin in urine. As the kidney disease becomes more severe, the blood pressure tends to continue to rise.
As the kidney disease progresses, the ability of the kidneys to filter and rid the body of waste products decreases. Then, it is a case of kidney failure. Normally, minor or even moderate kidney failure does not have any symptoms.
Anaemia is a common sign of moderate kidney failure. Symptoms of anaemia include tiredness and reduced efficiency. Symptoms of severe kidney failure include a loss of appetite, feeling nauseous, unintentional weight loss, itchy skin and leg cramps.