Diabetic Kidney Disease (Stages 1–4)

Being told your kidney numbers are slipping is frightening — the word "dialysis" can start to feel like it's hanging over everything. It doesn't have to be. When we act early, kidney decline can often be slowed for years. Our nephrology-guided program focuses on protecting the function you still have, with a clear plan you and your family can follow together.

Meet Our Specialists
Overview

Slowing kidney decline through early intervention

Diabetic kidney disease often progresses silently through stages 1–4. Early detection of a falling eGFR and protein in the urine allows intervention that can meaningfully slow decline — long before symptoms appear.

Every kidney program at Boston Diabetes is reviewed by our U.S. nephrology advisor Dr. Barbara Ann Greco, MD (Harvard Medical School / UMass Chan — over 35 years in kidney care and transplantation). Meet our specialists guiding your care.

Signs we monitor

  • Rising serum creatinine
  • Falling eGFR
  • Protein or albumin in urine (proteinuria)
  • Swelling in feet or ankles
  • Uncontrolled blood pressure
  • Fatigue or reduced appetite

Protect function before dialysis

Structured renal-risk management can delay or prevent progression to end-stage disease. The earlier we intervene, the more kidney function we can preserve.

The Boston Standard Care Pathway

Every program follows the same three-stage pathway — comprehensive assessment, personalized intervention, and continuous outcome measurement.

Care Pathway

Three stages, one goal — protect your kidneys

1

Comprehensive Assessment

eGFR staging, urine ACR, a full blood-pressure profile and a review of your current medications to establish where your kidneys stand.

2

Personalized Intervention

Kidney-protective therapy with tailored blood-pressure and glucose targets, dietary guidance, and careful avoidance of nephrotoxic drugs.

3

Continuous Measurement

Repeat eGFR and ACR tracking confirms that progression is slowing — so care stays guided by results, not assumptions.

Related Programs

Explore other complication programs

Protect your kidneys — starting today

There's more within your control than it may feel like right now. One consultation shows you exactly where your kidneys stand, and how to protect them.

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