Diabetic nephropathy or diabetic kidney disease is a serious complication that affects people with type 1 and type 2 diabetes. Up to 40% of individuals with diabetes develop kidney disease. The kidneys are two small, bean-shaped organs that balance fluids in the body, remove waste products from the blood, and produce urine. Diabetic nephropathy damages the kidneys over the years and can result in end-stage renal disease. The best way to slow the disease's progression and prevent complications is to start treating diabetic nephropathy as early as possible.

Symptoms of Diabetic Nephropathy

There are five stages of diabetic nephropathy. In the early stages, an individual may not experience any symptoms. Later stages cause an increased need to urinate, protein in the urine, reduced blood pressure control, less need for diabetic medication or insulin, nausea and vomiting, loss of appetite, fatigue, confusion and difficulty concentrating, persistent itching, and swelling of the ankles, feet, hands, and eyes.

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End-Stage Renal Disease

Diabetic nephropathy can progress to end-stage renal disease, and the two conditions share many symptoms. In addition, individuals with end-stage renal disease can experience muscle cramps, twitches, and sleep disturbances. Chest pain and breathing difficulties are symptoms of fluid buildup around the heart.

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Cause of Diabetic Nephropathy

When diabetes damages cells in the kidneys, diabetic nephropathy develops. Over time, high blood sugar in people with untreated diabetes results in high blood pressure, which puts greater pressure on the organs. This gradual damage to the kidneys leads to kidney failure. Experts believe high blood pressure both contributes to the development and is a side effect of diabetic nephropathy. Poorly managed high blood pressure can increase the rate at which diabetic nephropathy progresses.

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Complications of Diabetic Nephropathy

Several complications may develop over months or years as a result of diabetic nephropathy, including:

  • Hyperkalemia, a sudden increase in potassium levels in the blood.
  • Anemia.
  • Blood vessel and heart disease, which may result in a stroke.
  • Fluid retention, which may result in fluid build-up in the lungs, swelling in the legs and arms, and high blood pressure.
  • Pregnancy complications.
  • Diabetic retinopathy or damage to the blood vessels in the retina.
  • General damage to the nerves or blood vessels, which can cause erectile dysfunction, foot sores, and diarrhea.
  • End-stage renal disease.

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Diabetic Nephropathy Risk Factors

Being a smoker, or having diabetes type 1 or type 2, high blood sugar that is difficult to control, high blood cholesterol, or a family history of diabetes and kidney disease all put a person at risk of developing diabetic nephropathy.

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Diabetic Nephropathy Diagnosis

Anyone experiencing the symptoms of diabetic kidney disease should visit a doctor, who will investigate medical and family histories and symptoms, and execute a physical exam. The physician may refer their patient to an endocrinologist, a doctor who specializes in diabetes, or a nephrologist, a kidney specialist. Blood tests can tell doctors how well the kidneys are functioning, and a urine test can look for proteins. High levels of a protein called microalbumin could indicate kidney damage. X-rays and ultrasounds show the kidneys' structure and size. Imaging tests such as CT and MRI scans can indicate how well blood is flowing through the kidneys.

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Diabetic Nephropathy Treatment

Medications can treat the early stages of diabetic kidney disease. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can address high blood pressure. Medications called statins help decrease cholesterol and protein in the urine. Several medications effectively decrease blood sugar levels. Other medications may be effective for generally improving the function of the kidneys.

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End-Stage Renal Disease Treatment

A person who has end-stage renal disease must either receive dialysis or get a kidney transplant. Dialysis uses a machine to remove excess fluid and waste products from the blood. Hemodialysis and peritoneal dialysis are the two most common types. For the former, a medical professional connects the patient to an artificial kidney machine for three to five hours about three times each week. Peritoneal dialysis can be performed at home. Kidney transplants are an option for some individuals with end-stage renal failure.

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Managing Diabetic Nephropathy with Lifestyle Changes

Several lifestyle behaviors can improve diabetes control. Doctors recommend people be active for at least 30 minutes on most days. Maintaining a healthy weight also helps manage the symptoms and side effects of diabetes. A nutritionist can help individuals create healthy meal plans and lose weight effectively and healthily. People with diabetic nephropathy should remain vigilant, keeping their doctor apprised of their condition and any changes, and keeping watch for symptoms of UTIs, for which immediate treatment should be sought.

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Preventing Diabetic Nephropathy

Managing diabetes is an essential part of delaying or preventing diabetic kidney disease. Diet, exercise, and medications are often effective practices. Maintaining a healthy weight and quitting smoking can help prevent or delay the onset of kidney disease. Controlling high blood pressure, high cholesterol, and other medical conditions is also important.

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