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Kidney disease or damage that occurs in people with diabetes is called diabetic nephropathy. This condition is a complication of diabetes.
Diabetic nephropathy; Nephropathy - diabetic; Diabetic glomerulosclerosis; Kimmelstiel-Wilson disease
Each kidney is made of hundreds of thousands of small units called nephrons. These structures filter your blood and help remove waste from the body.
In people with diabetes, the nephrons slowly thicken and become scarred over time. The kidneys begin to leak and protein (albumin) passes into the urine. This damage can happen years before any symptoms begin.
Kidney damage is more likely if you:
Often, there are no symptoms as the kidney damage starts and slowly gets worse. Kidney damage can begin 5 to 10 years before symptoms start.
People who have more severe and long-term (chronic) kidney disease may have symptoms such as:
Your health care provider will order tests to detect signs of kidney problems.
A urine test looks for a protein called albumin leaking into the urine.
Your health care provider will also check your blood pressure. This is because if you have diabetic nephropathy, you likely also have high blood pressure.
A kidney biopsy is ordered to confirm the diagnosis.
If you have diabetes, your health care provider will also check your kidneys by using the following blood tests every year:
When kidney damage is caught in its early stages, it can be slowed with treatment. Once larger amounts of protein appear in the urine, kidney damage will slowly get worse.
Follow your health care provider's advice to keep your condition from getting worse.
Keeping your blood pressure under control (below 130/80) is one of the best ways to slow kidney damage.
CONTROL YOUR BLOOD SUGAR LEVEL
Eating a low-fat diet, taking drugs to control blood cholesterol, and getting regular exercise can also help prevent or slow kidney damage.
You can also slow kidney damage by controlling your blood sugar levels, which you can do by:
OTHER WAYS TO PROTECT YOUR KIDNEYS
The health care provider may need to stop some of your medicines because they can harm your kidneys if diabetic nephropathy is getting worse.
Call your health care provider if you have diabetes and you have not had a urine test to check for protein.
American Diabetes Association. Standards of medical care in diabetes -- 2013. Diabetes Care. 2013;36 Suppl 1:S11-S66.
Parving H, Mauer M, Fioretto P, et al. Diabetic nephropathy. In: Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 38.
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