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Diabetic nephropathy is kidney damage that occurs with diabetes. It is the job of the kidneys to:
Damage from diabetes can prevent the kidneys from working well. In some cases, this can lead to kidney failure.
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Blood passes through small filters in the kidneys. Changes in the blood vessels due to diabetes can cause damage to these filters. Blood sugar levels that are not well-controlled can have the greatest impact on the kidney filters.
Over time, the damage to the filters increases. The damaged filters cannot clean the blood properly and protein from the blood can leak into the urine. If left untreated, this can lead to kidney failure.
Before symptoms appear early indications may include:
Symptoms may not appear until the kidney damage is severe. Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids will be tested. This can be done with:
You may have an ultrasound of your kidneys
If testing shows severe kidney disease you may have a kidney biopsy
Talk with your doctor about the best treatment plan for you.
Treatment is aimed at preventing or slowing further kidney damage. It may involve lifestyle changes and medications. Diabetes and blood pressure will both need to be controlled. This may help prevent further kidney damage.
Lifestyle changes that will help control your blood sugar and blood pressure include:
Your doctor may prescribe medications to help control blood sugar, reduce protein in the urine, protect your kidneys, and treat high blood pressure, such as:
If the damage to your kidneys progresses to kidney failure, you may need dialysis. Dialysis takes over for your kidneys. Blood passes out of your body into a machine. The machine filters waste out of the blood then pumps blood back to you.
If the kidney failure progresses you may eventually need a kidney transplant.
To help reduce your chances of diabetic nephropathy:
American Diabetes Association
National Kidney Foundation
Canadian Diabetes Association
The Kidney Foundation of Canada
Bjornstad P, et al. Early Diabetic Nephropathy in Type 1 Diabetes – New Insights. Curr Opin Endocrinol Diabetes Obes. 2014 Aug; 21(4): 279–286. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138314/
Diabetic nephropathy. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113702/Diabetic-nephropathy. Updated August 18, 2016. Accessed August 24, 2017.
Diabetic nephropathy. Cleveland Clinic website. Available at: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/diabetic-nephropathy/. Accessed August 24, 2017.
Diabetic nephropathy. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/diabetic-nephropathy/. Updated June 2017. Accessed August 24, 2017.
Kidney Disease (Nephropathy). American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html?referrer=https://www.google.com/. Updated February 9, 2017. Accessed August 24, 2017.
Last reviewed September 2018 by September 2017 Michael Woods, MD, FAAP Last Updated: 8/24/2017