Someone you love lives with diabetes. Become their Kidney Detective.
Diabetes can quietly hurt the kidneys — the body's hard-working filters — along with the heart and blood vessels. The good news: kidney trouble can be found early with two simple tests, and families can help protect kidneys every day. Your mission starts here.
Yá'át'ééh! — that's "hello, it is good" in Diné Bizaad, the Navajo language. A special welcome to Navajo-speaking families: this site — and the Family Card below — were made with you in mind.
Three generations, one team: a grandmother, two parents, and two kids looking out for each other. Every family is welcome here.
🌍 Families visit here from around the world
Start the case
Your kidneys: two small filters doing four big jobs
You have two kidneys, each about the size of your fist, tucked under your ribs in your back. Every day they filter all of your blood, over and over — about 50 gallons a day. Here is what they do while you are busy living your life.
1 · Clean the blood
Kidneys wash waste and extra stuff out of your blood. The waste leaves as urine — that's the kidneys taking out the trash, all day and all night.
2 · Balance the water
Drink a lot, and your kidneys let extra water go. Drink a little, and they hold on to it. They keep the amount of water in your body just right.
3 · Help control blood pressure
By balancing water and salt and sending chemical signals, the kidneys help set your blood pressure. Kidneys and blood pressure are a team.
4 · Build blood and bones
Kidneys send a signal that tells your body to make red blood cells, and they switch on vitamin D so your bones stay strong.
The tricky part: kidney trouble is quiet
Kidneys can lose a lot of their filtering power without hurting at all. Most people with early kidney damage feel completely fine. That's why detectives don't wait for clues you can feel — they use two tests that find kidney trouble early, while it can still be slowed down.
Test 1 · Urine test
The urine albumin test (ACR)
Healthy kidneys keep protein in the blood where it belongs. When the tiny filters are damaged, a protein called albumin leaks into the urine — one of the very first signs of kidney trouble.
How it works: a simple urine sample at the clinic. No needles. The lab compares albumin to creatinine — that's the ACR.
Test 2 · Blood test
The eGFR blood test
This blood test estimates how well the kidneys are filtering — the eGFR, or "filter score." Higher is better. It shows how much filtering power the kidneys have left.
How it works: one small blood draw. Doctors look at the eGFR together with the urine ACR to see the whole picture.
Know your kidney numbers — ask for both tests every year
Urine albumin (ACR)
Under 30 mg/g No leak found — filters are holding.
30 or more A leak — early kidney damage. Time to act, not panic.
eGFR (filter score)
90 or above Usual healthy range.
60–89 Watch it · Under 60 for 3+ months means kidney disease range — make a plan with the doctor.
Everyone with diabetes should have the urine albumin test and the eGFR checked at least once a year — even when they feel perfectly fine. Feeling fine is exactly when these tests matter most.
The whole case
Four panels, one team: diabetes, blood pressure, heart, kidneys
Kidney patients usually don't have just one problem. Diabetes, high blood pressure, and heart disease travel together — and each one can hurt the kidneys. A good detective works all four panels of the case at once.
1
Diabetes — the sugar story
Diabetes is the #1 cause of kidney damage. Year after year of high blood sugar wears out the kidneys' tiny filters.
Think of blood sugar like sand in a stream. A little passes through fine, but too much, for too long, grinds down the filters. Keeping glucose near target is the single strongest way to protect the kidneys — and it protects the eyes, nerves, and heart at the same time.
Family jobs: help your loved one check glucose, cheer for walks after meals, and make water the easy drink at home. Every "on target" day is a day the filters are safe.
Detective targets (ACE / AACE)
Fasting glucose under 110 mg/dL
A1C at or below 6.5%
Urine albumin + eGFR checks every year
2
Blood pressure — the pressure story
High blood pressure is the #2 cause of kidney damage — and damaged kidneys push blood pressure even higher. It's a loop, and controlling pressure breaks it.
The kidney's filters are tiny, delicate blood vessels. Pressure that runs too high batters them like a garden hose turned up too strong. Bringing pressure down is proven to slow kidney damage — and it protects the heart and brain, too.
Family jobs: go easy on salt at the table, take pressure medicines every day (not just on "high" days), and check home readings if the doctor asks.
Detective targets (2025 AHA / ACC guideline)
Under 130/80 for everyone with hypertension
Systolic under 120 encouraged for higher-risk adults
These are personal targets — always check with your own doctor
3
Cholesterol & the heart — the partner story
Kidneys and heart fail together. Kidney disease raises heart risk, and a struggling heart starves the kidneys of blood flow. Protect one, and you protect the other.
After a heart attack or stroke, cholesterol control becomes urgent detective work. The European heart guidelines (ESC/EAS) set a clear goal: get LDL cholesterol under 55 mg/dL and at least 50% lower than where it started, with a statin taken every day.
Family jobs: the statin works only on the days it's taken — help make "every day" easy with a pill box and a routine tied to breakfast or bedtime.
Detective targets (ESC / EAS guidelines)
After a heart attack or stroke: LDL under 55 mg/dL
And at least 50% lower than the starting LDL
A statin every day — it only works when taken
Important for moms-to-be:
If you are pregnant, breastfeeding, planning a pregnancy, or could become pregnant while taking the pill — tell your doctor right away. Statins are usually paused during pregnancy, and the plan is revisited after the baby comes.
4
Kidney-protecting medicines — the shield story
Some medicines do double duty: they treat diabetes or blood pressure and shield the kidneys themselves. KDIGO — the global kidney guideline group — now recommends them.
SGLT2 inhibitors started out as diabetes medicines that lower glucose through the urine. Big studies then showed something bigger: they slow kidney damage and protect the heart, even helping people whose kidneys are already weakened. KDIGO now recommends them for people with type 2 diabetes and kidney disease.
ACE inhibitors and ARBs are blood-pressure medicines that also take pressure off the kidney filters and reduce protein leaking into the urine — a classic kidney shield when albumin is leaking.
GLP-1 medicines — weekly shots (like semaglutide) that lower blood sugar and help with weight — protect the heart, and they protect the kidneys too: in a large study of people with diabetes and kidney disease, they slowed down the loss of kidney filtering (the GFR). Ask your doctor whether one is right for you.
These are prescription medicines a doctor chooses. This panel doesn't tell anyone to start a pill — it teaches families what the medicines are for, so they can ask smart questions at the next visit.
Ask the doctor
"Have my urine albumin and eGFR been checked this year?"
"Would an SGLT2 inhibitor help protect my kidneys?"
"If protein is leaking, should I be on an ACE inhibitor or ARB?"
"Are all my numbers — sugar, pressure, LDL — at target together?"
Important for moms-to-be:
If you are pregnant, breastfeeding, planning a pregnancy, or could become pregnant while taking the pill — tell your doctor right away. ACE inhibitors, ARBs, and statins are usually paused during pregnancy, and the plan is revisited after the baby comes.
Detective training
Kidney games
Train like a kidney detective. The clues from all four panels — sugar, pressure, cholesterol, and the kidney tests — are hidden inside the games.
Kids Games
12 games
Start here, young detectives: catch, match, sort, race, and spell your way through the kidney clues.
Game 1 · Filter Frenzy
Kids game
You are the kidney filter! Move the filter basket with your mouse, finger, or arrow keys. Catch the good drops — water and healthy foods. Dodge the salt shakers and sugar cubes: catching one costs a heart. You have 45 seconds and 3 hearts.
Score: 0Hearts: 3Time: 45s
Game 2 · Memory Match — Kidney Clues
Kids game
Flip two cards at a time and find all six matching pairs of kidney clues.
Pairs found: 0 / 6Flips: 0
Game 3 · Word Search — Kidney Words
Kids game
Find the seven hidden words. Tap the first letter of a word, then tap its last letter — words run across, down, or diagonally.
Game 4 · Myth or Fact?
Kids game
Kidney cases are full of rumors. Read each statement and call it: myth or fact?
Case 1 / 6Score: 0
Game 5 · Case Files — Kidney Quiz
Kids game
Six real cases from the four panels. Pick the right answer — a true detective checks every number.
Case 1 / 6Score: 0
Game 6 · Sort the Snacks
Kids game
A snack appears — you decide. Is it great for kidneys, or one to go easy on? Sort all eight cards.
Card 1 / 8Score: 0
Game 7 · Tap the Target Number
Kids game
Detectives memorize their targets. Tap the right number for each clue — every target comes straight from the four panels.
Question 1 / 8Score: 0
Game 8 · Match the Job
Kids game
Your kidneys do four big jobs. Tap a job on the left, then tap what that job does on the right. Match all four pairs.
Pairs matched: 0 / 4
Game 9 · True or False — Kidney Edition
Kids game
Eight quick statements about your kidneys. True or false? No guessing — a detective checks the facts.
Statement 1 / 8Score: 0
Game 10 · Unscramble the Clue
Kids game
The clue words got scrambled! Read the clue, then tap the letter tiles in order to rebuild each word.
Word 1 / 6Score: 0
Game 11 · Helps or Hurts?
Kids game
Everyday habits can protect the kidneys — or quietly work against them. Sort each habit card into the right group.
Card 1 / 10Score: 0
Game 12 · Kidney Quiz Race
Kids game
Sixty seconds on the clock. Answer as many quick kidney questions as you can before time runs out!
Press Start and get ready, detective…
Score: 0Time left: 60s
Teen Games
15 games
For older detectives: kidney numbers, dialysis, the protecting medicines, and full case work — everything from the four panels, at full strength.
Teen Game 1 · Dialysis Decoder
Teen game
When kidneys can no longer filter, dialysis takes over the cleaning job. Six questions on what dialysis does — and what it doesn't do.
Question 1 / 6Score: 0
Teen Game 2 · Know Your Numbers
Teen game
No choices this time — type the real targets from the panels and the kidney-numbers table, then check yourself.
Teen Game 3 · Read the Results
Teen game
Lab results land on your desk. Read each ACR or eGFR result and file it: filters holding, watch it, or act — see the doctor.
Result 1 / 8Score: 0
Teen Game 4 · Medicine Match
Teen game
Four medicines from Panel 4 and the heart panel. Tap a medicine, then tap the job it does. Match all four pairs.
Pairs matched: 0 / 4
Teen Game 5 · Medicines & Pregnancy — the Safeguard Cases
Teen game
The panels carry one rule in a red box: if you are pregnant, breastfeeding, or planning a pregnancy, tell your doctor right away — some medicines are paused during pregnancy. Work the cases.
Case 1 / 6Score: 0
Teen Game 6 · Myth or Fact — Level 2
Teen game
Harder rumors this time — dialysis, GFR numbers, and the medicines. Call each one: myth or fact?
Statement 1 / 8Score: 0
Teen Game 7 · Case Files II — Spot It Early
Teen game
Kidney trouble is quiet, so the numbers have to speak. Six cases — read every result like a detective.
Case 1 / 6Score: 0
Teen Game 8 · The 50% Challenge
Teen game
After a heart attack or stroke, the ESC/EAS goal is two rules at once: LDL under 55 mg/dL and at least 50% lower. Do the math on each case.
Challenge 1 / 6Score: 0
Teen Game 9 · Pressure Points
Teen game
Blood-pressure readings, one at a time. Sort each into normal, elevated, or high — remember, 120/80 is normal and the treatment target is under 130/80.
Reading 1 / 8Score: 0
Teen Game 10 · Word Builder
Teen game
Build each kidney word letter by letter from the tile pool. Wrong letters cost a strike — three strikes and the word is revealed. Watch out for decoy tiles!
Word 1 / 6Strikes: 0 / 3Score: 0
Teen Game 11 · Spot the Risk
Teen game
Ten cards on the board — some raise the risk of kidney damage, some protect against it. Tap every card that is a risk, then check your detective work.
Risks spotted: 0 / 6
Teen Game 12 · Plan the Visit
Teen game
A great kidney check-up runs in order. Tap the steps in the right order, from first to last.
Teen Game 13 · Teen Number Race
Teen game
Seventy-five seconds, nothing but numbers: thresholds, targets, and ranges from the panels. How many can you nail?
Press Start and get ready, detective…
Score: 0Time left: 75s
Teen Game 14 · Word Search — Expert Round
Teen game
Seven harder words from the case file are hiding in this grid. Tap the first letter of a word, then tap its last letter.
Teen Game 15 · The Grand Case
Teen game
One family, one patient, every panel at once. Work Grandpa R.'s case step by step — the way a real kidney detective would.
Step 1 / 6Score: 0
Take it home
The Kidney Family Card
The card that goes on the fridge and into the pharmacy bag — the reason for taking every pill, every day, in the family's own words.
I take my medicine for:
Write the name of the person you're staying healthy for. Then remember: the medicine works on the days you take it — every day.
Fasting glucose < 110A1C ≤ 6.5%BP < 130/80LDL < 55 after heart attack or strokeUrine albumin + eGFR every year
Yá'át'ééh! — hello to our Navajo-speaking families. In Diné Bizaad, that means "it is good." This card is for you, too.
For grown-ups
The full case file
Kidney disease in diabetes is common, silent, and slow-moving — which is precisely why it is worth catching. Two cheap tests (urine ACR and eGFR) find it years before symptoms. Once found, the four panels above are the plan: glucose at target, blood pressure controlled, LDL down after any heart attack or stroke, and kidney-protecting medicines — an SGLT2 inhibitor and, when albumin leaks, an ACE inhibitor or ARB — as KDIGO recommends.
Questions that open the conversation
"When were my urine albumin (ACR) and eGFR last checked — and what were the numbers?"
"Are my sugar, blood pressure, and LDL all at target at the same time?"
"Would an SGLT2 inhibitor protect my kidneys? Is an ACE inhibitor or ARB right for me?"
"How often should we recheck my kidney numbers?"
Everyday kidney protection
Take medicines every day — set a routine and a pill box.
Go easy on salt; most of it hides in processed and restaurant food.
Be careful with over-the-counter pain pills (NSAIDs like ibuprofen) — ask before using them regularly.
Don't smoke; keep moving; keep every yearly kidney check on the calendar.
Important for moms-to-be:
If you are pregnant, breastfeeding, planning a pregnancy, or could become pregnant while taking the pill — tell your doctor right away. Statins, ACE inhibitors, and ARBs are usually paused during pregnancy, and the plan is revisited after the baby comes.