Diabetic nephropathy is kidney damage that occurs with diabetes.
It is the job of the kidneys to: Filter bloodCatch needed substances and return them to circulationCreate urine to pass waste out of the body
Damage from diabetes can prevent the kidneys from working well. In some cases, this can lead to
Anatomy of the Kidney
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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.
Symptoms may not appear until the kidney damage is severe. Symptoms may include: Fluid buildup may appear as swelling in feet or handsWeaknessLoss of appetiteDifficulty sleepingConfusion and trouble concentrating
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with: Blood tests Urine tests
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. Your doctor will also work with you to help control your diabetes and blood pressure. This may help prevent further kidney damage.
Lifestyle changes that will help control your blood sugar and blood pressure include:
Lose weight if you are
Exercise.Eat less salt.If you smoke, talk to your doctor about ways to quit.Avoid alcohol.Follow your diabetes management plan.
Your doctor may prescribe medications to help control blood sugar and protect your kidneys, such as: Angiotensin-converting enzyme inhibitors (ACE inhibitors)Angiotensin receptor blockers (ARBs)
If the damage to your kidneys progresses to kidney failure, you may need
. 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.
If the kidney failure progresses you may eventually need a
To help reduce your chances of getting diabetic nephropathy, take the following steps: See your doctor regularly. During checkups, you will have your blood pressure, urine, blood, and organs monitored for changes.Control blood sugar levels.
Follow your diabetes treatment regimen as directed.
Work with your doctor to maintain a healthy blood pressure (less than 130/80 mmHg).Exercise daily.If you smoke, talk to your doctor about ways to quit.
American Academy of Family Physicians.
Information from your family doctor: diabetic nephropathy.
Am Fam Physician. 2005 Jul 1;72(01):100.
Diabetic nephropathy. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated September 15, 2014. Accessed September 18, 2014.
Diabetic nephropathy. Family Doctor—American Academy of Family Physicians website. Available at:
http://familydoctor.org/online/famdocen/home/common/diabetes/complications/847.html. Updated February 2014. Accessed September 18, 2014.
Living with diabetes: kidney disease (nephropathy). American Diabetes Association website. Available at:
http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html. Updated December 10, 2013. Accessed September 18, 2014.
Nephropathy in diabetes.
Diabetes Care. 2004;27 Suppl 1:S79-83.
Last reviewed August 2014 by Kim Carmichael, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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