Diabetes with Chronic Kidney Disease

Diabetes with chronic kidney disease (CKD) needs a lab strategy that watches blood sugar and kidney function at the same time. A proactive plan starts with eGFR/creatinine to track filtering, urine albumin/creatinine ratio (uACR) to detect early kidney damage, and A1c for long-term glucose control. Because A1c can be less reliable in advanced CKD or anemia, your clinician may add fructosamine or glycated albumin for shorter-term feedback. Safety labs—potassium, bicarbonate (CO2), sodium, calcium/phosphate, liver tests—help monitor medicines and metabolic balance.

Lab testing can identify kidney stress early, guide follow-up timing, and build a clear baseline for trends. Testing cannot manage diabetes or CKD by itself, replace a clinician’s exam, or provide treatment advice. Use results with your history, home readings or CGM (if used), and scheduled visits.

Signs, Symptoms & Related Situations

  • Possible high glucose: thirst, frequent urination, fatigue, blurred vision, slow-healing cuts.

  • Kidney clues: swelling in legs or around eyes, foamy urine, rising blood pressure, nighttime urination.

  • Electrolyte issues: muscle weakness or irregular heartbeat (possible high potassium).

  • Anemia signs: shortness of breath with exertion, pale skin, low energy.

  • Bone–mineral symptoms (advanced CKD): bone pain or itching.

  • When to seek urgent care: chest pain, severe shortness of breath, confusion, vomiting with rapid breathing (possible ketoacidosis), or weakness/arrhythmia with suspected high potassium.
    All symptoms should be evaluated by a qualified clinician.

Why These Tests Matter

What testing can do

  • Detect albuminuria and falling eGFR early to prompt closer follow-up.

  • Track short- and long-term glucose control and verify when A1c may be unreliable.

  • Monitor electrolytes, acid–base status, and bone–mineral balance that change with CKD.

  • Screen for anemia of CKD and assess cardiovascular risk.

What testing cannot do

  • Replace medical evaluation or guideline eye/foot/heart exams.

  • Explain every change in numbers—hydration, illness, medicines, and timing matter.

What These Tests Measure (at a glance)

  • eGFR & Creatinine (Kidney Filtering): gauges kidney function stage (G1–G5). Caveat: trend over time; consider cystatin C for confirmation when needed.

  • Urine Albumin/Creatinine Ratio (uACR): detects albumin loss (A1 <30 mg/g; A2 30–300; A3 >300). Caveat:confirm persistence with repeat tests.

  • Comprehensive Metabolic Panel (CMP) / Basic Metabolic Panel (BMP): potassiumsodiumbicarbonate (CO2)chlorideglucosecreatinineCaveat: potassium and CO2 guide safety and acid–base status.

  • A1c (2–3-month average): long-term control. Caveat: less reliable with anemia, EPO use, hemoglobin variants, or advanced CKD.

  • Fructosamine or Glycated Albumin (2–3-week average): short-term control or A1c alternative. Caveat: affected by low albumin, thyroid disease, or protein loss.

  • Fasting / Post-Meal Glucose: “today” control and after-meal spikes. Caveat: follow timing and prep.

  • Lipid Panel: LDL, HDL, triglycerides for heart risk. Caveat: be consistent with fasting status.

  • CBC (Hemoglobin/Hematocrit): checks for anemia of CKD. Caveat: interpret with iron studies.

  • Iron Panel (Ferritin, Transferrin Saturation): iron status in CKD anemia work-ups. Caveat: ferritin rises with inflammation.

  • Calcium, Phosphate, Intact PTH, 25-OH Vitamin D: bone–mineral balance in CKD. Caveat: use as a group to understand trends.

  • Urinalysis (± Protein/Creatinine Ratio): complements uACR with sediment and protein data. Caveat: acute illness can transiently change results.

How the Testing Process Works

  1. Start with a CKD-aware set: eGFR/creatinine + uACR + CMP/BMP + A1c; add lipids and CBC/iron for risk and anemia.

  2. Collect samples: standard blood draw and a spot urine for uACR (follow any fasting instructions).

  3. View results securely: most labs post within a few days to your online account.

  4. Review with your clinician: align labs with home readings/CGM, blood pressure, and medicines; decide next steps.

  5. Monitor trends: repeat at agreed intervals to track both kidney and glucose control.

Interpreting Results (General Guidance)

  • eGFR: watch direction and pace of change; a steady decline needs closer follow-up.

  • uACR: persistent A2–A3 albuminuria signals higher risk; confirm with repeat testing.

  • A1c vs. reality: if A1c and home/CGM data disagree, consider fructosamine/glycated albumin and review anemia/variants.

  • Potassium/CO2: rising potassium or low bicarbonate merits prompt clinician review.

  • Bone–mineral: rising PTH with phosphate changes suggests mineral imbalance.
    Always interpret results with a qualified healthcare professional.

Choosing Panels vs. Individual Tests

  • Baseline in diabetes with CKD: eGFR/creatinine + uACR + CMP/BMP + A1c + lipid panel + CBC/iron.

  • If A1c is unreliable or rapid changes are expected: add fructosamine or glycated albumin, plus post-meal glucose when spikes are suspected.

  • If electrolytes or acid–base shift: repeat BMP and consider medication review with your clinician.

  • For bone–mineral evaluation (progressive CKD): add calcium, phosphate, PTH, 25-OH vitamin D.

  • For persistent proteinuria or atypical findings: add urinalysis ± protein/creatinine ratio and discuss further work-up.

FAQs

How often should I check kidney labs if I have diabetes?
Your clinician sets the schedule; many people repeat eGFR/creatinine and uACR at regular intervals based on CKD stage and albuminuria.

Is A1c reliable in CKD?
It can be less reliable with anemia, EPO use, or advanced CKD. Fructosamine or glycated albumin can add context.

Which labs warn about dangerous potassium levels?
The BMP reports potassium and bicarbonate (CO2); abnormal values need prompt review.

Do I need urine tests if my eGFR is okay?
Yes. uACR can reveal early kidney damage even when eGFR is normal.

What labs look at bone and mineral balance in CKD?
Calcium, phosphate, PTH, and 25-OH vitamin D together show trends in mineral metabolism.

Can dehydration or illness change my kidney results?
Yes. Hydration, infections, and medicines can shift creatinineuACR, and electrolytes—share recent events with your clinician.

Internal Links & Cross-References

  • Diabetes Tests Hub

  • Diabetes Management

  •  Blood Sugar Monitoring

  • Kidney Health (Microalbumin)

  • Lipid Panel & Heart Risk

  • A1c Testing

  • Key Lab Tests: eGFR/Creatinine • Urine Albumin/Creatinine Ratio • CMP/BMP (Potassium, CO2) • A1c • Fructosamine • Glycated Albumin • Lipid Panel • CBC • Ferritin/Transferrin Saturation • Calcium • Phosphate • Intact PTH • Vitamin D • Urinalysis

References

  1. American Diabetes Association. Standards of Care in Diabetes—Chronic Kidney Disease.

  2. Kidney Disease: Improving Global Outcomes (KDIGO). 2024 Clinical Practice Guideline for the Evaluation and Management of CKD.

  3. KDIGO. 2022 Guideline for Diabetes Management in CKD.

  4. National Kidney Foundation (KDOQI). Albuminuria and GFR Categories—Risk Stratification.

  5. National Institute of Diabetes and Digestive and Kidney Diseases. CKD Basics and Diabetes & Kidney Disease.

  6. National Glycohemoglobin Standardization Program. Factors That Interfere With HbA1c Results.

  7. International Federation of Clinical Chemistry. Harmonization of Cystatin C and eGFR Estimation.

  8. American College of Cardiology/American Heart Association. Lipid Management Guidance for High-Risk Patients.

Available Tests & Panels

Your diabetes-with-CKD test menu is pre-populated in the Ulta Lab Tests system. Start with eGFR/creatinine, uACR, CMP/BMP, and A1c, then add fructosamine/glycated albumin when A1c is unreliable, plus lipids, CBC/iron, and bone–mineral markers as advised. Use filters to compare individual markers and bundled panels, and review all results with your clinician.

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Name Matches
Blood, Urine
Blood Draw, Phlebotomist, Urine Collection

Blood, Urine
Blood Draw, Phlebotomist, Urine Collection

Blood, Urine
Blood Draw, Phlebotomist, Urine Collection

Blood, Urine
Blood Draw, Phlebotomist, Urine Collection


The Complete Blood Count with Differential and Platelets Test is a comprehensive blood test that checks red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The differential analyzes types of white blood cells to detect infections, anemia, clotting abnormalities, immune conditions, and certain cancers. This essential test is often ordered for routine health exams, diagnosis, and monitoring treatment progress.

Blood
Blood Draw
Also Known As: CBC Test, CBC with Differential and Platelets Test, CBC w/Diff and Platelets Test, Full Blood Count Test, Complete Blood Count Test

The Comprehensive Metabolic Panel (CMP) Test measures 21 markers to assess metabolic health, liver and kidney function, and electrolyte balance. It includes glucose, calcium, sodium, potassium, chloride, CO2, albumin, globulin, A/G ratio, total protein, bilirubin, ALP, AST, ALT, BUN, creatinine, BUN/creatinine ratio, and eGFR. The CMP helps detect diabetes, liver or kidney disease, and supports routine screening and chronic condition monitoring.

Blood
Blood Draw
Also Known As: CMP Test, Chemistry Panel Test, Chem Test, Chem 21 Test, Chem 14 Test 

The Hemoglobin A1c (HbA1c) Test measures average blood glucose over 2–3 months by detecting sugar attached to hemoglobin in red blood cells. It is used to diagnose diabetes, identify prediabetes, and monitor long-term blood sugar control. Doctors rely on the HbA1c test to evaluate treatment effectiveness, guide adjustments, and assess risk for complications, making it essential for diabetes care and metabolic health screening.

Blood
Blood Draw
Also Known As: A1c Test, HbA1c Test, Glycated Hemoglobin Test

Most Popular

The Insulin Test measures insulin levels in blood to assess how the body regulates glucose and metabolism. It helps diagnose insulin resistance, hypoglycemia, type 2 diabetes, and metabolic syndrome. Doctors also use it to evaluate pancreatic function and monitor treatment effectiveness. Frequently ordered with glucose testing, the insulin test provides critical insight into endocrine health, blood sugar control, and risk for diabetes-related complications.

Blood
Blood Draw
Also Known As: Fasting Insulin Blood Test

The Lipid Panel with Ratios Test measures seven key markers: total cholesterol, HDL, LDL, non-HDL cholesterol, triglycerides, Chol/HDL ratio, and LDL/HDL ratio. This advanced panel evaluates cardiovascular risk by assessing cholesterol balance and fat metabolism. Doctors use it to detect high cholesterol, atherosclerosis risk, and heart disease, and to monitor treatment. Often part of routine exams, it provides insight into long-term heart and metabolic health.

Also Known As: Lipid Profile Test, Cholesterol Panel Test, Lipid Blood Test

The Apolipoprotein A1 and B Test measures Apo A1, the main protein in HDL cholesterol, and Apo B, the primary protein in LDL and VLDL cholesterol. Together, these markers and the ApoB/A1 ratio provide a clearer picture of cardiovascular risk than standard lipid panels. High ApoB or low Apo A1 may signal heart disease, stroke, or atherosclerosis. Doctors use this test to evaluate cholesterol balance, monitor therapy, and guide prevention of cardiovascular conditions.

Blood
Blood Draw
Also Known As: Apo A1 and B Test, Apolipoprotein Evaluation Test

The C-Reactive Protein (CRP) Test measures CRP levels in blood to detect inflammation in the body. Elevated CRP may indicate infections, autoimmune disorders, or chronic diseases such as arthritis, cardiovascular disease, or inflammatory bowel disease. Doctors use this test to assess acute illness, monitor treatment response, and evaluate risk for heart disease. The CRP test provides key insight into inflammation, immune health, and overall wellness.

Blood
Blood Draw
Also Known As: CRP Test, Inflammation Test

The Carbon Dioxide Test measures CO2 levels in the blood to help assess acid-base balance and metabolic function. Abnormal results may reflect respiratory issues, kidney disorders, or metabolic imbalances such as acidosis or alkalosis. This test is often included in electrolyte panels to provide insights into overall health, fluid balance, and how the body maintains proper pH regulation through the respiratory and renal systems.

Blood
Blood Draw
Also Known As: CO2 Test

The Cardio IQ™ Diabetes and ASCVD Risk Panel with Scores measures advanced cardiovascular and metabolic markers to evaluate risk for atherosclerotic cardiovascular disease and type 2 diabetes. This panel includes lipid analysis, glucose-related biomarkers, and inflammation indicators, helping assess cardiometabolic health. Results provide clinicians with detailed scoring to identify patterns that may influence prevention and long-term disease management.


The Cardio IQ™ Diabetes Risk Panel with Score combines advanced biomarker analysis to evaluate insulin resistance, lipid metabolism, and glycemic control. This panel generates a diabetes risk score that helps identify individuals at increased risk for type 2 diabetes and related cardiometabolic complications. It provides insight into metabolic health, supporting early intervention, lifestyle planning, and long-term disease management.


The Catecholamines Fractionated Plasma Test measures plasma levels of dopamine, epinephrine, and norepinephrine, hormones that regulate stress response, blood pressure, and heart rate. Elevated levels may indicate pheochromocytoma, paraganglioma, or other adrenal and nervous system disorders. Doctors use this test to investigate symptoms like hypertension, headaches, sweating, or palpitations, and to monitor treatment of adrenal tumors.

Blood
Blood Draw

Most Popular

The Creatinine Test measures creatinine levels in blood to evaluate kidney function and filtration efficiency. Elevated levels may indicate kidney disease, dehydration, or muscle disorders, while low levels may reflect reduced muscle mass. Doctors use this test to monitor chronic kidney disease (CKD), assess treatment response, and detect early signs of renal impairment. It provides key insight into kidney health, metabolic balance, and overall renal function.

Blood
Blood Draw
Also Known As: Blood Creatinine Test, Serum Creatinine Test

The Cystatin C Test with eGFR measures blood levels of Cystatin C, a protein filtered by the kidneys, and calculates estimated glomerular filtration rate (eGFR). This test provides a sensitive marker for kidney function and can detect early kidney disease, even when creatinine levels are normal. Doctors order it to evaluate chronic kidney disease risk, monitor treatment, and assess overall kidney health in patients with diabetes, hypertension, or other conditions.

Blood
Blood Draw
Also Known As: CysX Test, CysC Test

The Diabetes Risk Panel with Score combines multiple biomarkers to assess risk of developing type 2 diabetes and related metabolic conditions. By evaluating glucose control, insulin resistance, lipid levels, and inflammation markers, this panel provides a personalized score that reflects overall metabolic health. Clinicians use it to help identify individuals at increased risk, support early intervention, and monitor long-term health.


Most Popular

The Ferritin Test measures ferritin, a protein that stores iron in the body, to evaluate iron levels and detect deficiency or overload. It helps diagnose anemia, iron deficiency, hemochromatosis, and chronic disease-related inflammation. Doctors often order the ferritin test to investigate fatigue, weakness, or unexplained symptoms. It is also used to monitor iron supplementation, treatment effectiveness, and overall iron metabolism health.

Blood
Blood Draw
Also Known As: Iron Storage Test

The Glucagon Test evaluates hormone levels that regulate glucose by stimulating the liver to release stored sugar. Elevated or low glucagon may indicate diabetes, hypoglycemia, metabolic disorders, or pancreatic disease. This test provides insight into endocrine activity, glucose balance, and systemic health conditions related to energy metabolism and hormonal function.

Blood
Blood Draw

The Hemoglobin Test measures the amount of hemoglobin in blood, the protein that carries oxygen to tissues. Low hemoglobin may indicate anemia, blood loss, or nutritional deficiencies, while high levels may suggest dehydration, lung disease, or bone marrow disorders. Doctors order this test to evaluate fatigue, weakness, or shortness of breath. Results provide key insight into oxygen transport, red blood cell health, and overall hematologic function.

Blood
Blood Draw
Also Known As: Hgb Test

The Lyme Disease Antibody Test with Reflex to Blot IgG IgM screens for antibodies to Borrelia burgdorferi, the bacteria that cause Lyme disease. If results are positive or equivocal, a Western blot IgG/IgM is reflexively performed for confirmation. Doctors order this test for patients with tick exposure, rash, joint pain, or neurological symptoms. Results help confirm infection, guide treatment decisions, and support early detection to prevent complications.

Blood
Blood Draw
Also Known As: Borrelia burgdorferi Test, Lyme Disease Antibodies IgG IgM Immunoblot Test, Lyme Disease Ab Test

The Albumin 24 Hour Urine with Creatinine Test measures albumin and creatinine excretion over 24 hours to evaluate kidney function. Elevated albumin (albuminuria) may signal early kidney disease, diabetes-related damage, or hypertension. By comparing albumin to creatinine, this test accounts for urine concentration and improves accuracy. Doctors use it to detect kidney injury, monitor chronic disease, and guide treatment or prevention strategies.

Urine
Urine Collection
Also Known As: Urine Albumin Test, 24 Hour Microalbumin Test

The Albumin 24 Hour Urine Test evaluates the amount of albumin released in urine during a full day, serving as an indicator of kidney health. High albumin levels can signal early kidney damage from diabetes, hypertension, or chronic kidney disease. Collecting urine over 24 hours improves accuracy by reflecting daily fluctuations, offering important insight for detecting renal impairment, monitoring progression, and supporting long-term care.

Urine
Urine Collection
Also Known As: Urine Albumin Test, 24 Hour Microalbumin Test

Diabetes is the leading cause of kidney failure. More than 247,000 people are currently living with kidney failure that resulted from diabetes.

Diabetes is categorized by high levels of sugar in the blood. One of the long-term side effects of these changes in the cardiovascular system is the destruction of small blood vessels throughout the body. Unfortunately, this leads to kidney damage which can lead to chronic kidney disease and kidney failure.

Diabetes with chronic kidney disease is nothing small. Patients with both conditions have to have a physician monitor them regularly. If you're a diabetic who isn't getting regular testing, you could have kidney problems and not know.

To learn more, keep reading.

What Is Diabetes With Chronic Kidney Disease?

As stated before, diabetes with chronic kidney disease (also known as diabetic nephropathy) is the manifestation of chronic kidney disease that stems from diabetes. It should be noted that you can develop chronic kidney disease whether you have controlled or uncontrolled diabetes.

The damage to your small blood vessels can still happen even if you're within optimal ranges. However, keeping your diabetes controlled can reduce your risk of developing chronic kidney disease.

Risk Factors for Diabetes With Chronic Kidney Disease

The number one risk factor for chronic kidney disease is having diabetes, either type one or type two. With this, there are a few other risk factors to consider:

  • High blood sugar that is not controlled
  • High blood pressure that is not controlled
  • Smoking
  • High cholesterol

Lastly, patients with a family history of diabetes with chronic kidney disease are more likely to develop the conditions themselves.

Causes of Diabetes With Chronic Kidney Disease

As mentioned earlier, diabetes could cause damage to the blood vessels that cluster in your kidneys. These blood vessels are responsible for filtering all of the waste from the blood in your body. Therefore, if these blood vessels become damaged, this can lead to decreased kidney function and even kidney failure.

Chronic kidney disease is a common complication of both type one and type two diabetes.

Poorly controlled diabetes is more likely to lead to this complication than well-controlled diabetes. However, anyone with diabetes could develop the condition.

Too much sugar in the blood could cause kidney damage and lead to high blood pressure. This leads to even more complications as high blood pressure can lead to more kidney damage. This cycle happens repeatedly as high blood pressure leads to kidney damage which leads to high blood pressure.

What Are the Signs and Symptoms of Diabetes With Chronic Kidney Disease?

The early stages of diabetic nephropathy don't come with any signs or symptoms. You could be developing chronic kidney disease and not know it until you're in the latter stages of development. This is why it's so important to get kidney lab tests done regularly, especially if you have diabetes.

If the kidney disease does develop into later stages, some signs and symptoms may begin manifesting:

  • Hypertension (high blood pressure)
  • Proteinuria (protein in the urine)
  • Lower extremity edema (swelling in the legs, ankles, and feet)
  • Swelling in the eys
  • Increased frequency of urination
  • Reduced need for insulin or other diabetic medication
  • Confusion
  • Difficulty concentrating
  • Shortness of breath
  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue
  • Persistent itchy skin

If you have diabetes and you're experiencing any of these symptoms, you should make an appointment with your primary care physician or your endocrinologist. Either healthcare provider can examine your symptoms and interpret your test results.

How Is Diabetes With Chronic Kidney Disease Diagnosed?

To diagnose diabetic nephropathy, healthcare providers have to gather plenty of information.

First, they're going to ask questions about your personal and family history. They're going to ask about your habits and symptoms as well.

Then, they're going to order blood and urine tests to examine how controlled or uncontrolled your diabetes is. These tests can also help them examine your kidney health.

In addition to these tests, your healthcare provider may order a CT scan or an MRI to look at your kidneys. Lastly, they may require a biopsy if your kidneys do appear compromised.

The Lab Tests to Screen, Diagnose, and Monitor Diabetes With Chronic Kidney Disease

If you're looking to get diabetes with chronic kidney disease tests, Ulta Lab Tests has a few different panels to choose from:

Our comprehensive panel tests for the most biomarkers. With this panel, you'll get the best look at your diabetes condition and kidney health.

Here are the biomarkers that our comprehensive panel looks for:

  • Apolipoprotein - a measure of proteins that bind to lipids in the blood
  • C-Reactive protein - a general marker of inflammation
  • CBC - a general panel that looks at red blood cells, white blood cells, and platelets
  • Comprehensive metabolic panel - a panel that looks at electrolytes in the blood
  • Cystatin C with eGFR - a protein controlled by kidneys
  • GlycoMark - a plasma test for monitoring glucose variability
  • Hemoglobin A1C - a measure of blood glucose over the past three months
  • Insulin - a measure of glucose-controlling hormone in the blood
  • Lipid panel with ratios - a measure of lipids (fats) in the blood
  • Microalbumin - a protein in the blood
  • Phosphate - a measure of phosphorous in the blood
  • PTH - parathyroid hormone
  • QuestAssure - a measure of vitamin D in the blood

Getting all of these labs will help you and your healthcare provider make better decisions about your health.

Get Your Diabetes Tests With Ulta Lab Tests

If you have diabetes, you need to check the health of your kidneys. Diabetes with chronic kidney disease can lead to life-altering complications.

That's why physicians recommend that patients with diabetes get regular kidney testing. Luckily, Ulta Lab Tests offers the diabetes tests that you need. We offer highly accurate and reliable tests so that you can make informed decisions about your health.

Here are some of the benefits that you get to experience if you order your tests from Ulta Lab Tests:

  • You'll get secure and confidential results
  • You don't need health insurance
  • You don't need a physician's referral
  • You'll get affordable pricing
  • We offer a 100% satisfaction guarantee 

Order your diabetes tests today, and you'll receive your results securely and confidentially online in 24 to 48 hours for most tests. With your results, you and your healthcare provider can take preventative measures against chronic kidney disease before it can develop.

Take control with Ulta Lab Tests today!