By the time swelling, breathlessness or nausea appear, most patients have lost 60–70% of their kidney function. There are almost no early symptoms, which is exactly why screening matters.
The two tests that matter
A serum creatinine with eGFR, and a urine albumin-to-creatinine ratio. Together they cost very little and can detect kidney damage years before symptoms. Anyone with diabetes, high blood pressure, or a family history of kidney disease should have both annually.
Five habits that protect kidney function
- Control blood pressure tightly. A target below 130/80 slows progression more than any single medication choice.
- Keep HbA1c near target. Diabetes is the leading cause of kidney failure in India.
- Stop routine painkiller use. Regular NSAIDs — the tablets people take for every headache and body ache — are a common and avoidable cause of kidney injury.
- Drink adequate, not excessive, water. Around 2–2.5 litres a day for most adults. Litres beyond that do not "flush" the kidneys.
- Be careful with unregulated supplements. We regularly admit patients with kidney injury from heavy-metal-contaminated or protein-loaded products taken without supervision.
About creatinine numbers
A single mildly raised creatinine is not a diagnosis. Muscle mass, hydration and recent exercise all affect it. What matters is the trend over time, alongside the urine protein result.
If you already have chronic kidney disease
Progression can be slowed substantially. Modern medications — SGLT2 inhibitors in particular — have changed the outlook considerably in the last few years. Many patients who were told a decade ago that dialysis was inevitable are still doing well without it.
