Brief Answer:
You need evaluation.

Detailed Answer:
Hi Mr. XXXX,

Thanks for choosing HCM.
Noted your concern.

Considering your age and duration of diabetes (around 2 years) the possibility of diabetes induced nephropathy is less likely.

Other causes should be considered, important of which are urinary infection, renal stones (back ache may point out towards stone or infection) also pain killers may cause kidney problem.

Detailed clinical examination including blood pressure measurement is important.

In such case I may suggest following investigations-
- HbA1c.
- Complete Blood Count.
- Renal Function Test - Urea, Creatinine, Electrolytes, Uric Acid,
- Calcium profile.
- Liver Function Test.
- Urine examination and if pus cells present culture and sensitivity.
- Ultrasound of Abdomen and Pelvis for Kidney size, shape, Echotexture.
- Fundoscopy to Know changes of Diabetic & Hyperensive Retinopathy.

Depending upon detailed clinical examination and above evaluation appropriate decision can be taken.

Metformin itself wont cause kidney problem but deranged kidney function may affect metaboloism of metformin and precipitate its side effects.

Hope this helps you.

Regards,
Dr. Abhay Mali.
Diabetologist.

---

Brief Answer:
You may not have major kidney issue.

Detailed Answer:
As I have already mentioned diabetes is unlikely a cause for your kidney problem which is further supported by no evidence of diabetic retinopathy on fundocscopy.

In your blood test reports there is-
- Vitamin D deficiency which requires correction.
- Also there may not be a major kidney problem as except micro-albuminuria and marginal rise in serum urea all other investigations are within acceptable range.

Simple dehydration may also be the cause for marginally elevated urea.
Heavy exercise, fever, urinary infection, dehydration may cause proteinuria.

For the sake of complete evaluation I may suggest Ultrasound of abdomen and pelvis, urine examination.

Hope this helps you.

---