eGFR Guidelines for Diabetes: What You Need to Know

When you have diabetes, your estimated glomerular filtration rate, a measure of how well your kidneys filter waste from your blood. Also known as eGFR, it’s one of the most important numbers your doctor tracks—not just for your kidneys, but for your whole diabetes plan. If your eGFR drops below 60 for three months or more, it signals chronic kidney disease, which is common in people with long-term diabetes. The American Diabetes Association says everyone with diabetes should get an eGFR test at least once a year. That’s not a suggestion—it’s a standard part of care because kidney damage often has no symptoms until it’s advanced.

What does eGFR actually tell your doctor? It’s not a direct measurement. It’s calculated using your age, sex, race, and blood creatinine level. A normal eGFR is above 90. If it’s between 60 and 89, your kidneys are working okay but might be starting to struggle. Below 60 means moderate to severe loss of function. Below 15? That’s kidney failure, and you’ll need dialysis or a transplant. The diabetic kidney disease, a progressive condition caused by high blood sugar damaging the tiny filters in the kidneys doesn’t happen overnight. It creeps in over years, which is why regular eGFR checks are your best defense. The CKD staging, a system that classifies kidney disease based on eGFR and urine protein levels helps doctors decide when to change medications, refer you to a specialist, or tighten blood sugar control.

Some diabetes meds, like SGLT2 inhibitors and GLP-1 agonists, are now used not just for blood sugar, but to protect your kidneys—even if your eGFR is already low. That’s why knowing your number matters. If your eGFR falls, your doctor might stop certain drugs that can build up in your system and cause harm. Other times, they’ll push harder on blood pressure control, because high BP and diabetes together are a deadly combo for your kidneys. You won’t feel this damage coming, but your eGFR will. And when you see it drop, you know it’s time to act—not wait.

Below, you’ll find real-world insights from doctors, patients, and pharmacists on how eGFR guides treatment, what to ask your provider, and how to protect your kidneys before it’s too late. These aren’t theory pieces—they’re practical guides based on what’s actually working in clinics and homes today.