Confidential information: Almost 80% of diabetic patients are unaware of the risks to their kidneys

Almost 80% of patients with type 2 diabetes are not aware of the risks to their kidneys, said Galina Goretskaya, chairman of the board of the public organization Nephro-League. At the same time, such concomitant diseases are asymptomatic for a long time, which is why doctors cannot diagnose them in time. Late detection of kidney diseases leads to serious complications, including cardiovascular disasters, said Evgeny Shilov, chief freelance nephrologist at the Ministry of Health.

Patients are unaware of the risks to their kidneys

Only 5% of people with type 2 diabetes receive all the necessary information from doctors related to the risk of kidney damage. This was revealed during a survey conducted in March 2026 by the public organization Nefro-League. At the same time, about 77% of people with this disease are not aware of such risks at all, said Galina Goretskaya, chairman of the organization, at the round table "Nephrodiabetes: a new reality and algorithms of action" in the Izvestia press center.

— More than half of these patients are forced to search for information on the Internet themselves. The issue of awareness plays a crucial role for the patient's life. And lack of information is a direct path to serious complications," she said.

According to a number of studies, chronic kidney disease occurs in about 40% of patients with type 2 diabetes. The expert noted that the progression of the disease is difficult to slow down without proper diagnosis.

— To identify chronic kidney disease, it is necessary to take tests for albuminuria (elevated albumin protein levels are the earliest marker of kidney damage) and a blood test for creatinine (glomerular filtration rate in the kidneys). But half of the respondents do not receive appointments or are unaware of their existence. Many people say that they have never seen their tests, only some receive tests at their insistent request. This is a signal that risk control is more the exception than the norm," believes Galina Goretskaya.

Kidney diseases have been asymptomatic for a long time, said Minara Shamkhalova, MD, Head of the Department of Diabetic Kidney Disease and Post-Transplant Rehabilitation at the National Medical Research Center for Endocrinology.

— The kidneys are a very "patient" and "silent" organ, it does not make itself felt for a long time. This is a very difficult group of patients: low awareness of kidney risks goes hand in hand with late diagnosis. We're wasting time and the patient's prognosis is getting worse," she said. — This happens for a number of reasons. Doctors are given little time to see patients, there is no available literature for patients, and there is no interaction between specialists. A comprehensive approach is required, including nutritionists, psychologists, and endocrinologists.

Why early diagnosis is important

Type 2 diabetes in combination with chronic kidney disease often leads to damage to the cardiovascular system, warned Evgeny Shilov, MD, Chief freelance nephrologist at the Ministry of Health.

"This year, chronic kidney disease was recognized as the fifth most socially significant disease in the world," he said. — I would like to add optimism: at any stage, with type 2 diabetes and kidney disease, the patient can be helped. The only difference is in perspective. In case of early diagnosis, kidney involvement can be delayed for decades. But do not despair, as there is dialysis and transplantation.

Evgeny Shilov is sure that now doctors should focus their efforts on early diagnosis of diseases.

— There is a term — "left shift". The forces of our healthcare are focused on the treatment of diseases that are already in a severe stage. We need to turn the system around," he said.

Chronic kidney disease can occur not only in people with diabetes, but also in hypertension (persistent high blood pressure. — Ed.), obesity, high cholesterol and autoimmune diseases, said Yulia Sidorova, an endocrinologist at the Soft Medical Center clinic, to Izvestia.

— In the first stages, the disease does not manifest itself, because the kidneys "die" silently. Edema, high blood pressure, shortness of breath appear already in the late stages, when there is a pronounced organ lesion," she noted.

To prevent chronic kidney disease, it is recommended to limit salt and fat intake, drink enough water, take the necessary tests regularly, monitor blood pressure and body weight.

— Requires regular physical activity: at least 150 minutes of moderate activity per week, taking into account age and general condition. It can be walking, swimming, cycling," she noted.

Schools for people with kidney problems

To improve patient awareness, it is necessary to expand the network of schools for people with chronic kidney disease, Minara Shamkhalova noted. Currently, there are more than 20 such schools in Russia, but classes are held only online and not on a regular basis, the doctor said.

— The patient should not be a passive figure, — the doctor emphasized. — The success of the treatment ultimately depends on how much responsibility he takes on himself. Nutrition, weight control, physical activity, and quitting smoking and alcohol are very important.

Modern medicine is characterized by an approach in which both participants in the process — both the doctor and the patient — take an active position and share responsibility equally, said Tatyana Ivanova, a clinical psychologist and specialist at Alter platform.

— The doctor's duties include informing the patient about his diagnosis and recommendations, but this happens in a time-limited appointment, so he can only state the essence, — she said. — If the patient needs more detailed information, he is free to use the resources of literature, scientific articles and patient communities, returning to the doctor for the necessary clarifications.

In addition to informing, patient communities perform the function of mutual support. By joining them, a person begins to communicate with people with the same problem, which helps him not to feel lonely and excluded from society.

— Quite often there are situations when patients shift responsibility to the doctor. Which is not a mature position from a psychological point of view," Tatiana Ivanova added. — The disease often contributes to the activation of such a protective mechanism of the psyche as regression, which manifests itself in the fact that the patient returns to earlier, childish levels of development.

According to her, such a reaction is normal for the first stages of adaptation to the disease, but it is overcome over time. If a person cannot do this on his own, it significantly reduces his ability to adapt to the disease and continue to live a full life, therefore, in case of getting stuck at the stage of "regression", timely help from a psychologist is important.