Diabetic Nephropathy

Definition

Diabetic nephropathy is kidney damage that occurs with diabetes. It can keep the kidneys from doing their job of removing waste and extra fluid from the body. In some people, this can lead to kidney failure.

Anatomy of the Kidney.

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Causes

Blood passes through small filters in the kidneys. Changes in the blood vessels due to diabetes can cause damage to these filters. This can make it hard for them to clean the blood properly and cause protein from the blood to leak into the urine. If left untreated, this can lead to kidney failure.

Risk Factors

Things that may raise the risk of this problem are Type 1 diabetes and Type 2 diabetes with:

• Poor control of blood glucose levels
• High blood pressure—puts more stress on the kidneys and increases the risk of kidney damage
• High cholesterol

Symptoms

Symptoms may not appear until kidney damage is severe. A person may have:

• Weakness
• Lack of hunger
• Nausea and vomiting
• Swelling in the feet or hands
• Problems sleeping
• Confusion and trouble with focus

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done.

Blood tests will be done to check kidney function. Urine tests will be done to look for protein, which is an early sign of kidney damage.

If the diagnosis is not clear, a kidney biopsy may be done to check for damage.

Treatment

The goal of treatment is to prevent or slow damage. Diabetes and blood pressure will both need to be controlled. Treatment options are:

Prevention

People with diabetes and high blood pressure can lower the risk of this problem by following their care plan.