Why the kidneys fail silently

The kidneys filter close to 180 litres of blood a day and carry enough spare capacity that you can lose a large share of function without feeling anything at all. By the time swelling or fatigue appears, the change is usually well advanced.

Two tests worth asking for

A serum creatinine level gives an estimated filtration rate, and a urine albumin test catches protein leaking through the filter. Together they are the earliest reliable signal, and both are routine.

Who should test annually

Anyone with diabetes, high blood pressure, a family history of kidney disease, or long term use of anti inflammatory painkillers. If that is you, make the two tests part of your yearly visit rather than a separate appointment.