Diabeticnephropathyis a form of long-term, chronic kidney disease resulting from having had diabetes for several years.
Diabetes causes higher-than-normal blood glucose levels, which damage some of the kidneys blood vessels over time.
Damaged blood vessels in the kidneys and other factors, like inflammation, lead to kidney damage.
Kayoko Hayashi / Getty Images
Kayoko Hayashi / Getty Images
What Are the Symptoms of Diabetic Nephropathy?
Initially, diabetic nephropathy doesnt cause any symptoms.
However, symptoms arise as the kidneys worsen over time.
Some potentialsymptomscould include the following:
What Causes Diabetic Nephropathy?
Diabetic nephropathy is a complication of diabetes mellitus, a medical condition that leads tohigh blood glucose.
These types differ somewhat, but all involve the bodys ability to produce or respond to the hormoneinsulin.
Scientists arent completely clear why some people with diabetes develop kidney disease.
Elevated glucose may lead tolong-term damage to the blood vesselsin the kidneys.
However, diabetic nephropathy doesnt occur right when you first get diabetes.
It may take around 10 years to develop, though this can vary greatly.
Other Risk Factors
Some factors increase the chance that youll develop diabetic nephropathy.
For example, you have a higher risk of diabetic nephropathy if you are male or advanced in age.
Examples of additionalrisk factorsinclude:
You may improve these risk factors via lifestyle changes and medications.
However, symptoms are usually absent.
If not treated, stage 5 kidney disease leads to symptoms that are ultimately fatal, likecoma.
How Is Diabetic Nephropathy Diagnosed?
Usually, someone with diabetic nephropathy already knows that they have diabetes.
But if they dont, a healthcare provider will order blood tests for diabetes, likeblood glucoseandhemoglobin A1c.
Microalbuminuria Urine Tests
Microalbuminuriaurine testscan be used earliest in the disease.
People with kidney disease have higher ACRs.
Serum Creatinine Blood Test
Theserum creatininetest measures the amount of creatinine in the blood.
Healthcare providers use serum creatinine to calculate the estimated glomerular filtration rate (eGFR).
It is usually not needed to diagnose diabetic nephropathy.
How Is Diabetic Nephropathy Treated?
Your choices will depend on the pop in of your diabetes, its severity, and your personal preferences.
Some key examples include the following:
However, many other medications for diabetes are potential options.
Often, healthcare providers prescribe anACE inhibitor-bang out medicationlike Capoten (captopril).
These medications may not directly improve your kidneys but may help prevent heart attack and stroke.
Ideally, over 150 minutes of aerobic activity a week is recommended.
Quitting smoking is also essential.
However, you might need to consider your options during stage 4 disease.
Dialysis
The majority of people with end-stage kidney disease go ondialysis.
However, dialysis doesnt work as well as a normal kidney, which can be time-consuming.
Some people can now receive training to safely perform dialysis at home, potentially overnight.
Discuss all your dialysis options with yournephrologist(kidney specialist) or other healthcare provider.
Kidney Transplant
Some people with diabetic nephropathy can get akidney transplant.
In some cases, healthcare providers combine a kidney transplant with a pancreas transplant to treat diabetes directly.
Kidney transplants usually help people live longer and have a higher quality of life compared to dialysis.
Whats the Outlook for Someone With Diabetic Nephropathy?
People with diabetes who develop nephropathy have ahigher risk of mortalitythan people with diabetes who dont.
These risks increase with later stages of kidney disease.
Cardiovascular diseaseis a significant concern for all people with diabetes, including those who have diabetic nephropathy.
A significant number of people with diabetic nephropathy do eventually develop end-stage disease.
But not all do, especially those diagnosed early and optimally treated.
Summary
Roughly 40% of people with diabetes eventually develop diabetic nephropathy.
It usually doesnt happen until youve had diabetes for several years.
People with early-stage diabetic nephropathy often dont have any symptoms, so all people with diabetes need kidney monitoring.
Nordheim E, Geir Jenssen T.Chronic kidney disease in patients with diabetes mellitus.Endocr Connect.
2021;10(5):R151-R159.
2019;99(12):751-759.
2020;22(Suppl 1):3-15. doi:10.1111/dom.14007
Wouk N.End-stage renal disease: Medical management.Am Fam Physician.
2021;104(5):493-499.
Perez-Saez MJ, Pascual J.Kidney transplantation in the diabetic patient.J Clin Med.
2015;5(1):49-56.
