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:
Protein in your urine when it is tested
Elevated blood urea nitrogen and creatine when your blood is tested
High blood pressure
Symptoms may not appear until the kidney damage is severe. Symptoms may include:
Fluid buildup may appear as swelling in feet or hands
Loss of appetite, nausea, and vomiting
Confusion and trouble concentrating
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:
Blood tests to check kidney function
Urine tests to look for protein
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:
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.
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. 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.
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