Chronic Kidney Disease: The Early Numbers Worth Tracking
Kidney disease is diagnosed late in India because its early stages produce no symptoms and are found only in blood work most patients do not do routinely. By the time swelling, fatigue, or a change in urination is noticed, function is often already 30-40% below normal. A simple annual test — creatinine, eGFR, and urine microalbumin — catches most cases early enough that progression can be slowed.
The three numbers that matter
- Value: Serum creatinine · What it measures: Waste product filtered by kidneys · Concerning threshold: Rising over months, especially > 1.2 (men) / 1.0 (women)
- Value: eGFR · What it measures: Calculated filtration rate · Concerning threshold: < 60 mL/min for > 3 months
- Value: Urine albumin/creatinine ratio · What it measures: Protein leaking through kidney · Concerning threshold: > 30 mg/g
- Value: Blood pressure · What it measures: Both cause and consequence of CKD · Concerning threshold: > 130/80 sustained
- Value: Blood potassium · What it measures: Rises when kidneys fail · Concerning threshold: > 5.0
- Value: HbA1c (if diabetic) · What it measures: Long-term sugar control · Concerning threshold: > 7.0 accelerates decline
Who should test annually, from age 40
- Anyone with diabetes.
- Anyone with hypertension.
- Anyone with a family history of kidney disease.
- Anyone on long-term NSAIDs (arthritis, chronic pain).
- Anyone with recurrent urinary tract infections.
- Anyone with a history of kidney stones.
Slowing progression — what actually works
- Tight BP control (< 130/80). The single strongest intervention.
- Tight sugar control in diabetics.
- Reduce dietary salt to under 5g/day.
- Moderate protein — not high, not low (0.8g/kg/day for most).
- Avoid nephrotoxic drugs: NSAIDs, certain antibiotics, contrast dyes when avoidable.
- Treat any UTI promptly.
What the trend tells you
A single eGFR of 58 in an otherwise healthy adult may be a lab fluctuation. eGFR of 58 that was 72 two years ago is a trajectory. The record makes the difference visible. Most nephrologists want to see 12-18 months of data before deciding whether to escalate treatment — the person who has been tracking has evidence in hand; the person starting from a single value has to start monitoring first.
The referral moment
Refer to nephrology when eGFR drops below 45, or albumin rises above 300 mg/g, or the rate of decline is faster than 4 mL/min/year. A well-organised record with 3-5 years of creatinine and eGFR is what the nephrologist reads first at the first visit — the trajectory matters more than the current value.
References
Free for 90 days, no card needed. After that, keeping the record costs ₹349 for the year.
General information, not medical advice. Always talk to a qualified doctor about your own care. Where this and your doctor disagree, your doctor is right.