Assessment of kidney functions in diabetic patients: A mini review

Abstract

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia resulting from insufficient insulin production, impaired insulin action, or both. In autoimmune-mediated diabetes, pancreatic β-cells are progressively destroyed, leading to disrupted glucose metabolism. Prolonged hyperglycemia causes damage to small blood vessels and contributes to serious complications, including diabetic nephropathy, which may progress to end-stage renal disease requiring dialysis or kidney transplantation. The reported incidence of kidney failure ranges from 30-40% in patients with type 1 diabetes and 10-40% in those with type 2 diabetes. Early and accurate assessment of renal function is therefore essential for reducing morbidity and mortality among diabetic patients. This mini review focuses on the commonly used methods for evaluating kidney function in diabetes, with particular emphasis on glomerular function. Various biochemical and clinical approaches are discussed, including renal function tests, urine analysis, albumin-to-creatinine ratio (ACR), and estimation of glomerular filtration rate (GFR) using endogenous and exogenous markers such as inulin. Blood-based assays assessing protein concentrations and urine-based measurements of solute clearance, combined with mathematical models, remain fundamental tools for estimating GFR. Early detection of renal impairment through appropriate diagnostic strategies can significantly reduce the risk of renal complications in diabetic patients and improve long-term clinical outcomes.